- Asia Oceania Journal of Nuclear Medicine and Biology

Transcription

AsiaOceaniaJournalofNuclearMedicine&Biology
OfficialJournalofAsiaOceaniaFederationofNuclearMedicine&Biology(AOFNMB)
Volume2
Supplement1November2014
AbstractsofARCCNMAnnualCongress2014
Editorial
WelcometotheARCCNMCongress2014inOsaka
S1
S2
J.Hatazawa
ARCCNMAnnualCongress2014:Schedule
HonoraryInvitedLecture
S5
CETopics
S7
Oralsessions
S18
Posterpresentation(Part1)
S28
Posterpresentation(Part2)
S39
Abstracts
TheabstractspublishedinthisSupplementwerenotsubjecttothestandardpeer
reviewingprocessofAsiaOceaniaJournalofNuclearMedicine&Biology
Asia Oceania Journal of Nuclear Medicine & Biology
Official Journal of Asia Oceania Federation of Nuclear Medicine & Biology (AOFNMB) Editor in Chief:
Zakavi, Seyed Rasoul, Iran
Associate Editors:
Bailey, Dale, Australia
Kinuya, Seigo, Japan
Siraj, Qaisar, Kuwait
Managing Editor:
Sadri, Kayvan, Iran
-------------------------------------------------------------------------Editorial Board ------------------------------------------------------------------------Ahn, Byeong-Cheol, Korea
Hussain, Raihan, Bangladesh
Moon, Dae-Hyuk, Korea
Al Suhaili, AbdulRahim, UAE
Huang, Gang, China
Murakami, Koji, Japan
Alam, Faridul, Bangladesh
Huang, Wen-Sheng, Taiwan
Obaldo, Jerry, Philippines
Al-Sugair, Abdulaziz Saleh, Saudi
Arabia
Inoue, Yusuke, Japan
Ogbac, Ruben V., Philippine
Jalilian, Amir Reza, Iran
Pascual, Thomas, IAEA
Jeong, Hwan-Jeong, Korea
Pradhan, Prasanta Kumar, India
Kang, Keon-Wook, Korea
Sabih, Durr-e, Pakistan
Ay, Mohamadreza, Iran
Barrenechea, Emerita, Philippines
Beiki, Davood, Iran
Kairemo, Kalevi, Finland
Sadeghi, Ramin, Iran
Bin Abdul Khader, Mohamed Ali,
Malaysia
Kartamihardja, Hussein, Indonesia
Saengsuda, Yuthana, Thailand
Bom, Henry, Korea
Lee, Jaeseung, Korea
Saghari, Mohsen, Iran
Cho, Inho, Korea
Lee, Sze Ting, Australia
Sanluis, JR., Teofilo O.L., Philippines
Choi, Frankie, Hong Kong
Lee, Yoonsang, Korea
Sayman, Haluk B., Turkey
Choi, Joon Young, Korea
Liu Ren-Shyan, Taiwan
Sasaki, Masayuki, Japan
Dabbagh Kakhki, Vahidreza, Iran
Mai Trong, Khoa, Vietnam
Scott, Andrew, Australia
Elgazzar, Abdelhamid H., Kuwait
Malhotra, Arun, India
Thakur, Mathew L., USA
Erfani, Mostafa, Iran
Masoomi, Michael, UK
Toyama, Hiroshi, Japan
Hatazawa, Jun, Japan
Min, Jung-Joon, Korea
Ugur, Omer, Turkey
Hosseinimehr, Seyed Jalal, Iran
Mirzaei, Siroos, Austria
------------------------------------------------------------------------------------------------------------------------------------------------------------------------ISSN (print edition) 2322-5718
ISSN (electronic edition) 2322-5726
Abstracted and indexed in: DOAJ, EBSCO, Index Copernicus, ISC, IMEMR, Magiran
Editorial Office
Nuclear Medicine Research Center
Ghaem Hospital, Ahmadabad Ave, Mashhad, Iran
Postal Code: 91766-99199
Tel: ++98-51-38400494
Fax: ++98-51-38419521
E-mail: [email protected]
Asia Oceania J Nucl Med Biol (2014) volume 2, Supplement 1
The 13th Annual General Meeting of ARCCNM, Osaka, Japan
The 13th Annual General Meeting of the Asian Regional
CooperativeCouncilforNuclearMedicine
November5‐6,2014,Osaka,Japan
DearColleagues
OnbehalfoftheScientificProgramCommitteeofthe13thAnnualGeneralMeetingof
Asian Regional Cooperative Council for Nuclear Medicine (ARCCNM), welcome to the
13th Annual General Meeting of the ARCCNM held in November 5th and 6th, 2014, in
Osaka.Thisyear,morethanonehundredabstractswereregisteredfromanumberof
regions of Europe, North America, Middle East, and Asia. Almost 150 scientific and
educational abstracts will be presented during the Congress period. I am grateful to
yourgreateffortstorealizeourdream.
Asiaisnowthehottestspotinthedevelopmentandexpansionofnuclearmedicine
andmolecularimaging.IcordiallyinviteyoutotheARCCNM2014inOsakaandhopeto
meetnewfriendsaswellasoldfriends.
Wegoaheadtogethertothefutureofnuclearmedicine.
Sincerelyyours,
JunHatazawa,MD,PhD
CongressChairman
The13thAGMofARCCNM
DepartmentofNuclearMedicineandTracerKinetics
OsakaUniversityGraduateSchoolofMedicine
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Date:
November5‐6,2014
Venue:
OsakaInternationalConventionCenter
TimeTableofARCCNM2014
Nov.4
VisitingPET
CenterTour
10:00‐11:00
11:00‐12:00
OsakaInternational
ConventionCenter
(12FandMainHall)
CE3
New Radionuclide Therapy
andBNCT
PosterSession2
LuncheonSeminar
TerryJones
12:00‐13:00
ANMB
Examination
14:00‐15:00
15:00‐16:00
16:00‐17:00
17:00‐18:00
18:00‐19:00
Nov.6
Nakanoshima
OsakaInternationalConventionCenter
Center,Osaka
(12FConferenceHall)
University
9:00‐10:00
13:00‐14:00
Nov.5
HonoraryLecture
MyungChulLee
CE1
OralSession1
Immunologyand Nuclearoncology(1)
NuclearMedicine OralSession2
Nuclearoncology(2)
CE2
OralSession3
NewImaging
Nuclearcardiology,
ModalityandPET‐ neurology,and
MRI
generalnuclear
medicine
PosterSession1
LuncheonSeminar
Shanghai United Imaging
Healthcare
(12F)
JointCeremony
(MainHall)
NationalDelegatesMeeting
(12F,Room1202)
SpecialLecture
by Honorary Fellow of
ANMB
(12F,Room1202)
GlobalCollaborationin
NMEducationandTraining
(12F,Room1202)
S2
Program
ARCCNMContinuingEducationSession
This session is supported by the RCA Regional Office (Mr. Kun Mo Choi,
Director).
Wednesday,November5,201412F,ConferenceHall
14:00‐15:30ImmunologyandNuclearMedicine
15:30‐17:00NewImagingModalityandPET/MR
Thursday,November6,2014
9:00‐10:00NewRadionuclideTherapyandBoronNeutronCaptureTherapy
ARCCNMScientificSession
13:00‐14:00HonoraryLectureMyungChulLee
DrivingForcesfortheFutureof
NuclearMedicineCommunity
12F,Room1202
14:00‐15:00OralPresentation1NuclearOncology1
15:00‐16:00OralPresentation2NuclearOncology2
16:00‐17:00OralPresentation3NuclearCardiology,Neurology,and
GeneralNuclearMedicine
17:00‐18:30PosterPresentation1NuclearOncology
Thursday,November6,201412F,ConferenceHall
10:00‐12:00PosterPresentation2NuclearCardiology,Neurology,and
GeneralNuclearMedicine
16:00‐17:00SpecialLecturebyHonoraryFANMB12F,Room1202
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ARCCNMSymposium
Thursday,November6,201412F,Room1202
17:00‐19:00GlobalCollaborationofEducationandTrainingofNuclear
Medicine
LuncheonSeminar
12:00‐13:00TerryJones
FutureDevelopmentofPETTechnology
Thursday,November6,2014
12:00‐13:00HuangGang,Wai‐Hoi,Gary,Wong
VisualizingtheDawnofUltrahighResolutionPET/CTin
NuclearMedicine
(SponsoredbyShanghaiUnitedImagingHealthcareCO.,Ltd.)
Contactto:
ARCCNM/AOFNMBSecretariat
Address:6FSaehanBldg.106,Nambusunhwan‐ro356‐gil,
Seocho‐gu,Seoul,137‐888,Korea
Tel:+827088677996
Fax:+8230334417996
E‐mail:[email protected]
ARCCNM2014OsakaLocalOffice
DepartmentofNuclearMedicineandTracerKinetics
OsakaUniversityGraduateSchoolofMedicine
Address:2‐2Yamadaoka,Suita,Osaka,565‐0871,Japan
Tel:+81‐6‐6879‐3461
Fax:+81‐6‐6879‐3469
CongreCo.,Ltd.
Address:3‐6‐13Awaji,Chuo‐ku,Osaka,541‐0047
Tel:+81‐6‐6229‐2555
Fax:+81‐6‐6229‐2556
[email protected]
S4
2014; Vol 2, Supplement 1
HonoraryInvitedLecture
DrivingForcesfortheFutureofNuclearMedicineCommunity
Myung‐ChulLee,M.D.
KoreaArmedForcesCapitalHospital,Korea
NuclearmedicineisacomplexTechnologywhichisconstitutedbytheintegrationof
clinical practice, scientific research and strategic issues, supported by the inspiration,
aspiration and perspiration of its dedicated professionals, and sustained by the
consistent and systematic activities of various international and governmental
organizations. Throughout the last 40 years, nuclear medicine has emerged
dramaticallyasatrulypromisingfieldinKoreathroughtheprogressandproliferation
ofresearch,technologyandpracticewhichwasstimulatedbymultipledrivingforcesas
follows:foundationoftheKoreanSocietyofNuclearMedicine,publishingrelatedbooks
and printed materials, host of the 3rd Asia and Oceania Congress of Nuclear Medicine
andBiology,establishmentofKoreaBoardofNuclearMedicine,hostcountryforWorld
Federation and Congress of Nuclear Medicine and Biology, international cooperative
activity through IAEA, JSNM, SNM, CJK, EANM and ARCCNM, contribution by national
organizations such as Government, KAERI, Korea RI Association, etc, activated by the
Korean Society of Nuclear Medicine Technologist, dedication by related industrial
companiesandintroductionandexpansionofPET/CTtechnology.
Nowitistimetoseriouslyconsidertheanswerfortwofundamentalquestions:1.Isit
essentialhealthtechnology?2.Isitself‐survivableorself‐sustainable?Itisimportantto
recognize and emphasize the new driving forces of our role in promoting and
strengthening nuclear medicine community, based on vision, innovative changes and
networks,whicharemostimportantessentialityforgloballeadership.
The leadership program should be held as a very important essential function to
encourageallmemberstoberealpowerfulleadersinnuclearmedicinecommunity.We
needpowerfulleadersandexperiencedadvisorygroupstoprovidestrategicdirections
andproperguidance.Itisalsoessentialtobuildmultipleteamstoexpandandactivate
human network, institutional network, international network, industrial network and
strategicorpoliticalpartnershipnetwork.
The collaborative leadership through with national and international organizations
willofferaschemeofglobalsynergytotheoverallgrowthanddevelopmentofnuclear
medicine. It can improve global communication will encourage constant progress,
ultimately increasing harmony and success and strengthening nuclear medicine
community.
S5
InvitedLecture
FuturedevelopmentofPETmethodology
TerryJones
VisitingProfessoratUniversityofCaliforniaDavis
A major opportunity for future development rests on making more use of the
availablesignalemittedfromthewholeofthehumanbodyfollowingtheadministration
ofaPETtracer.ThisisillustratedbythefactthatwithcurrentPETscanners,lessthan
3% of the annihilation radiation emitted from the body is detected. Hence if a PET
scannercouldcoverthetotallengthofthebody,40timesmoresignalcouldberecorded
making more efficient use of the cost of producing the tracer and the radiation dose
incurred by the subject being scanned. Such an increase in efficiency would result in
beingabletoreduceconsiderablytheamountofradioactivityadministeredandhence
radiationdosetothesubjectbeingscanned.Thiswouldallowmorefrequentscanstobe
undertaken in the same subject and the scanning of patients currently excluded for
radiation dose reasons such as young children and pregnant women, see Jones and
Budinger. Increased efficiency would make possible the measurement of low density
diseasesuchasmicro‐metastasesseePriceetalaswellasinfectionandinflammation.
TheperformanceofsuchatotalbodyPETscannerhasbeensimulatedasa2metrelong
devise now referred to as the Ultra PET. Simultaneously recording of data from the
whole body offers an opportunity to undertake a “systems biology” range of studies
whichexamineinteractionsandactivationsbetweenorganssuchasbrain‐bodyaswell
as measuring the total body profile of the pharmacokinetics of a labelled drug to
support drug development. There will be many challenges in implementing the Ultra‐
PETscannerincludingcostwhichalthoughhighwouldbecomeaffordablewithvolume
productionandfurtherinnovationindetectortechnology.Oneexcitingchallengeliesin
undertaking data analysis of total body kinetic PET data. Even more exciting is the
prospectofengagingclinicianscientistsacrossthespectrumofinternalmedicinewhich
promisestorealizethefullpotentialofPETinclinicalresearchandhealthcare.
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CE‐1‐1
Cancer Control by Outpatient Thera‐nostics: Radioimmunotherapy of Non‐Hodgkin
Lymphoma and Radiopeptide Therapy of Neuroendocrine Tumours as Paradigms for Asia
andOceania
ProfessorJ.HarveyTurner
TheUniversityofWesternAustralia,FremantleHospital
Theprospectofcontrollingincurablecancerofhighprevalencebynoveloutpatientnuclearmedicinetherapiesof
high efficacy and low toxicity, which are affordable and practical throughout Asia and Oceania is now achievable.
Non‐Hodgkinlymphomaisthe5thcommonestcancerkiller,andwhilstincurable,itcanbeeffectivelycontrolledbya
single outpatient administration of
131I‐Rituximab
radioimmuno‐therapy, with minimal toxicity and durable
progression‐free survival. First‐line 131I‐Rituximab radioimmunotherapy of follicular non‐Hodgkin lymphoma has
achievedobjectiveresponserate(ORR)99%,andcompleteremission(CR)88%,withmediantime‐to‐nexttreatment
(TTNT) not reached after up to 7 years follow‐up. Iodine‐131 Rituximab radio‐immunotherapy of
relapsed/refractoryindolentNHLproducesORR67%,CR50%,medianPFS32monthsinCRpatients.Neitherfirst‐
line,norrelapsed/refractory,norrepeat 131I‐Rituximabradioimmunotherapyhasbeenaccompaniedbyanyepisode
ofbleedingorinfectionandnohospitaladmissionhasbeenrequired.Radiationexposuretooutpatientcarers,family
andmembersofthepubliciswithininternationalregulatoryguidelines.
Neuroendocrine tumours (NETs), whilst relatively uncommon, are slowly progressive and thus have high
prevalence.Theydonotrespondtochemotherapy,butpeptidereceptorradionuclidetherapy(PRRT)iseffectivefor
control of progression. Combination radiopeptide therapy with 4 cycles of 177Lu‐octreotate and radiosensitizing
capecitabine/temozolomidehasachievedORR57%,CR16%,PR41%,SD37%,inGEP‐NETSwithmedianPFS31
months.InpancreaticNETstreatedasoutpatientsonthisregimen,weobservedORR83%,CR13%,PR70%,SD20%
and median PFS was not reached at 40 month follow‐up. There is no long‐term haematological toxicity and with
aminoacidnephroprotectiontherewasnosignificantdepressionofrenalfunction.Patientswerealltreatedasday
patientswithnoradiationexposurerisktocarersorhospitalpersonnel.
S7
CE‐1‐2
Gallium‐68imaginginNeuroendocrinetumors
PrasantaKumarPradhan
SanjayGandhiPostGraduateInstituteofmedicalsciences,Lucknow,India
Neuroendocrinetumors(NETs)constituteaheterogeneousgroupofneoplasms,arisingfromendocrinecellswithin
glands (adrenal medulla, pituitary, parathyroid) or from endocrine islets in the thyroid, pancreas, respiratory and
gastrointestinal tract. Majority of NETs express somatostatin (SST) receptors, so they can be effectively targeted and
visualized with radiolabeled SST analogues in vivo. Scintigraphy with radiolabeled SST analogues, first with an I‐123
labelandsubsequentlywithan111Inand99mTclabel,hasprovenusefulindiagnosingSSTreceptorpositivetumours.The
detectionratewasreportedtobebetween80%and100%indifferentstudies.Thismethodalsoshowsthecontentof
SSTreceptorswhichmightindicateefficacyfortreatmentwithOctreotideorotherSSTanaloguesorradiolabeledDOTA
conjugate. Furthermore, there is evidence of a correlation between SST receptor expression and prognosis, since
patientswithNETsshowingapositiveprofileonthescanhaveabetterresponsetotreatmentwithSSTanalogues.
Radioiodinated (123I, 131I) MIBG is used to image and treat NETs, particularly those of the sympatho‐adrenal
system (pheochromo‐cytomas, paragangliomas and neuroblastomas), although other NETs (e.g. carcinoids,
medullarythyroidcarcinoma(MTC),etc.)arealsocandidatesfordiagnosisandtreatmentwith131IMIBG.MIBGwas
showntobelesssensitivefordetectingmetastaticlesionsofNETpatients.
TherecentintroductionofPETimagingwithGallium‐68hasmajorbearingsincurrentandfutureclinicalpracticein
neuroendocrineimaging.ItslabelingwithDOTAcompoundshasclearedthewayforsomatostatinreceptorimagingwith
aviablePETagent,withallitsinherentimagingadvantagescomparedtosinglephotonimaging(SPECT).Theclinical
applicationofthistechniquehasbeensuccessfulinavarietyoftumours,forstaging,restaging,monitoringresponseto
treatmentandplanningofpeptidereceptorradionuclidetherapy.ThevalueofGa‐68labeledpeptidepositronimaging
willbedemonstratedthroughrepresentativecases.
S8
CE‐1‐3
PETimagingofglialactivationinneurologicaldiseasesusinganimalmodels
MihoShukuri
LaboratoryofPhysicalChemistry,ShowaPharmaceuticalUniversity
In the central nervous system (CNS), glial cells, especially microglia, is known to be key players of the immune
defenseresponseagainstinvadingpathogens.Ontheotherhand,abnormalinflammatoryresponseinducedbyactivated
microgliamayalsoleadtotissueinjuryandneurodegeneration.Recently,muchattentionhasbeenpaidtotheroleof
activatedmicrogliaasatargetfordiagnosisandtherapyofthevariousneurologicaldiseasessuchasAlzheimer’sdisease,
stroke, and multiple sclerosis. Positron emission tomography (PET) is one of the in vivo imaging modality which
representsmolecularalterationsduringimmuneresponseinneurologicaldiseases.Inthistalk,weintroduceourrecent
researchonPETimagingstudiesforactivatedmicrogliainbrainsofanimalmodels.
Carbon‐11‐labeledDACisaPETprobewithhighaffinityandselectivitytothetranslocatorproteinTSPO(18kDa)
which is expressed on activated glial cells during neuroinflammation. We investigated glial activation at different
phasesofexperimentalautoimmuneencephalomyelitis(EAE)inratbrainsbyPETstudieswith11C‐DACunderinvivo
conditionandbypostmortemhistologicanalysis.Theincreaseof 11C‐DACuptakewasshowninallCNSareasatthe
peakofEAEclinicalepisodeandrecoverystage,butnotinpreclinicalstage.Thetimecourseof11C‐DACuptakeinthe
brainduringEAEepisodewascloselycorrespondedtotheexpressionpatternofactivatedmicrogliaandinfiltrated
macrophagesobservedinimmunohistochemicalanalysis.TheseresultssuggestthatPETimagingwith11C‐DACcould
beavaluablediagnostictoolformonitoringneuroinflammationinpathologicalprocessofmultiplesclerosis.
PurinergicreceptorP2X7Risaninitialregulatorofmicroglialactivationthroughthereleaseofproinflammatory
mediators such as IL‐1 and TNF, and is regarded as a promising target for therapy of immune‐related diseases
including multiple sclerosis. The GSK group developed a series of pyroglutamic acid amide analogues (PGAA) as
P2X7Rantagonists.Wesynthesized 11C‐labeledPGAAanalogstoexplorefurthermicroglialtargetsbyPET.ThePET
images of 11C‐PGAAs detected abnormal inflammatory microglial activation in the rat brains with hemispheric
neuroinflammationinducedbylipopolysaccharide.
WedemonstratedtheusefulnessofPETimagingforglialactivationinanimalmodelsofneurologicaldiseases.The
informationdescribedhereindicatesthatPETisdefinitelyhelpfulinsheddinglightonunderstandingthenatureof
diseaseprocessesandprovidesevidenceforclinicalapplications.
S9
CE‐1‐4
ClinicalTranslationof 99mTc‐3PRGD2SPECT/CTasacost‐effectivemethodfordiagnosis,
lymphnodestaging,andresponseevaluationofnon‐smallcelllungcancer
Zhaohui Zhu1, Xiaona Jin1, Shanqing Li1, Mengzhao Wang1, Bing Jia2, Quancai Cui1, Fang Li1, Ximin Shi1,
NaixinLiang1,JinmeiLuo1,YapingLuo1,YunxiaoMeng1,KunZheng1,ZhaofeiLiu2,JiyunShi2,FanWang2
1PekingUnionMedicalCollegeHospital,ChineseAcademyofMedicalSciencesandPekingUnionMedicalCollege,Beijing,China
2BingJia,ZhaofeiLiu,JiyunShi,FanWang,MedicalIsotopesResearchCenter,PekingUniversity,Beijing,China.
Background: A prospective translational study was designed to investigate a novel integrin receptor imaging
approach based on the cost‐effective single photon emission computed tomography/computed tomography
(SPECT/ CT) technology, using 99mTc‐3PRGD2 as the tracer, in diagnosis, lymph node staging, and response
evaluation of non‐small cell lung cancer (NSCLC), which was compared with
18F‐fluorodeoxyglucose
(FDG)
positronemissiontomography(PET)/CTinthesamepatients.
Patients and Methods: Sixty‐five patients with suspicious lung lesions were prospectively recruited. All patients
underwent 99mTc‐3PRGD2 SPECT/CT and18F‐FDG PET/CT within one week for initial evaluation. Among them, 21
patients with confirmed late‐stage NSCLC repeated both 99mTc‐3PRGD2 SPECT/CT and18F‐FDG PET/CT to monitor
theresponseafteronecycleandthreecyclesofplatinum‐basedchemotherapy.Twentyspecimensfromtheremoved
lunglesionsorlymphnodeswerestainedwithαvβ3‐integrin,CD34,andKi‐67tocorrelatewiththeimagefindings.
Results: According to Receiver Operating Characteristic curveanalysis and z statistics, 99mTc‐3PRGD2 SPECT/CT
showed a significantly higher value than 18F‐FDG PET/CT in assessing lymph node metastasis (z = 8.0, P<0.001),
whichhighlightedasignificantlyhigherspecificity(94.6%versus75.0%,P=0.004),whereasinthediagnosisoflung
lesions, no significant difference was found between the two methods (P=0.410). The late‐stage NSCLC had
significantly higher 99mTc‐3PRGD2 accumulation (P<0.05) but similar 18F‐FDG uptake. In response evaluation, the
99mTc‐3PRGD2 assessment seemed relatively stable with less influence from the physiological uptake variation as
commonly observed in 18F‐FDG PET/CT. The 99mTc‐3PRGD2 accumulation was positively correlated with αvβ3‐
integrinreceptorexpression(r=0.84,P=0.001)andmicrovesseldensity(r=0.63,P=0.011).
Conclusion: An effective method for integrin receptor imaging of tumor is established based on the cost‐effective
SPECT/CT technology with 99mTc‐3PRGD2 as the tracer. The advantages of this method in lymph node staging,
metastaticprognosis,andresponseevaluationmerititasanexcellenttechniquewithapromisetoexpandtheclinical
applicationofSPECT/CTinoncologyinabroadlyavailable,relativelylow‐costmannerthan18F‐FDGPET/CT.
S10
CE‐2‐1 DevelopmentofintegratedPET/MRIsystemsformolecularimaging
SeiichiYamamoto
DepartmentofRadiologicalandMedicalLaboratorySciences,NagoyaUniversityGraduateSchoolofMedicine,Nagoya,Japan
CollaborationgroupofNagoyauniversityandOsakauniversityhavedevelopedtwoopticalfiberbasedintegrated
PET/MRIsystemsforsmallanimalsandtwoSi‐PMbasedPETsystemsthatcanbecombinedwithMRIsystems.There
are some advantages and disadvantages in optical fiber based and Si‐PM based PET/MRI systems. The main
advantage of the optical fiber based PET system is less or no interferences between PET and MRI and the
disadvantage is the light loss of the fiber which degrades the performance of the PET. The advantage of the Si‐PM
based PET system is no light loss and the disadvantages are the interferences between PET and MRI and the
temperature dependent sensitivity changes. From our experiences, optical fiber PET systems are suitable for
combinedwithlowmagneticfieldMRIsystemsbecausethesignalleveloftheseMRIsystemsaresmallandsensitive
to the noise form PET systems. Si‐PM PET systems are suitable for higher magnetic field MRI systems probably
becausethesignallevelishigherenoughtoignorethenoisefromthePETsystemsalthoughsomeinterferencesform
RFandgradientsignalsmaydecreasetheperformanceoftheSi‐PMPETsystems.OneofouropticalfiberbasedPET
systememployed0.5mmdiameterdoublecladfiberswhichhave24mmx24mmrectangularoutputanddual12mm
x24mmrectangularinputs.TwotypesLGSOscintillatorswereopticallycoupledinDOIdirection,arrangedin11x13
matrixandopticallycoupledtothefiberbundle.Thetwoinputsofthebundlearebentfor90degrees,boundtoone,
and is optically coupled to a Hamamatsu 1‐inch square PSPMT. Eight optical fiber based block detectors were
arrangedinaringtoformaPETsystem.A0.3Topen‐MRIiscombinedwiththeopticalfiberPETsystem.Thespatial
resolution of the integrated PET system was 1.2mm and sensitivity was 1.2%, better than one of the Si‐PM PET
systems we developed. So we still feel optical fiber based PET systems are promising for new hybrid systems in
whichtheinterferencewithothermodalityiscritical.Si‐PMPETsystemsarepromisingforcombiningwithhighfield
MRIsbutweneedtominimizetheinterferencebetweenPETandMRIforbothmodalities.
S11
CE‐2‐2
ClinicalexperiencesandCurrentstatusofPET/MRimagingsysteminKorea
IhnhoCho
Departmentofnuclearmedicine,YeungnamUniversityHospital,Daegu,Korea
PET/MRimagingsystemhasevolvedslowly,butsteadilyoverthelast20yearstowardanintegratedsystemthat
allowsphysicianstohavemoreinformationaboutmetabolic,functionalandanatomicstateofthepathologiclesions
forthediagnosis,treatmentandmonitoringofvariousdiseases.SincetheideatocombinePETandMRIaroseasearly
asthemid1990s,threemodeltypesofcommercialPET/MRwasdeveloped.InKorea,PhilipswholebodyPET/MR
imaging system was installed for the first time. Since 2years ago, Siemens integrated whole body PET/MR system
withsimultaneousdataacquisitionhasbeenoperatingintwohospitals.AlsoGEHealthcaresystem,whichcombines
PET/CTandMRIbytransportingpatientsfromonemodalitytoanother,isrunninginonehospital.
PET/MR imaging may show the distribution of molecular tracers with picomolar sensitivity providing
information about cell metabolism and receptor status by PET and MRI supports superb soft‐tissue contrast
and functional information on perfusion, diffusion and metabolism without radiation exposure on the patient.
PET/MRhasthepotentialtobroadenourhorizonsintheemergingfieldofmolecularimagingintheoncology,
neurology and cardiology because complementary anatomic and biologic information is obtained and
synergism of both modalities can be expected. But this novel imaging technology should prove the impact on
diagnosticaccuracy,theeffectontherapymanagementandcost‐efficiencytoenterclinicalroutinestudy.
InKorea,F‐18FDGPET/MR imagingisapplied for stagingof head and neck cancer,breast cancer,hepatic
malignancyorrectalcancer.EspeciallyintegratedwholebodyPET/MRimagingisroutinetestsfornoninvasive
pediatric diagnostics in my hospital. Also we are trying to find potential applications of cardiac PET/MR
imaginginthefieldofcardiology.
Health care costs of the country is going up rapidly as other countries, so the government is trying to cut
imagingcostsinrecentyears.Assresult,thereimbursementfornewimagingtestsisdifficultandneedstoget
large randomized trials. Our insurance coverage is applied to PET or MRI, but not fusion PET/MR imaging. So
now there are a few hospitals with PET/MR scanner due to low cost‐effectiveness because it requires more
expensiveequipmentandlongeracquisitiontimesthanPET/CT.
In this section, I will present the clinical experiences of fully integrated whole body PET/MR imaging and the
currentstatusofKorea.
S12
CE‐2‐3
PET/MRI:TumorDiagnosisandOtherApplications
HiroshiIto
AdvancedClinicalResearchCenter,FukushimaMedicalUniversity,Japan
PETwith[18F]‐FDGcanmeasuretheglucoseconsumptionrateoftumorsinvivo,anditcanindicatetheproduct
of tumor cell density and energy metabolic activity. The intrinsic special resolution of PET camera is about 5 mm
which is not sufficient to obtain morphological information. PET/CT camera, which can obtain both the glucose
consumption rate and morphological images of tumors, has been widely used for diagnosis and evaluation of
treatment.MRIissuperiorintissuecontrastascomparedwithCTtoobtainmorphologicalinformation,especiallyin
softtissuetumorsoforthopedicfield.
Recently, PET/MRI camera, a PET camera with avalanche photodiode inserted into MRI gantry, has been
developed.PET/MRIcameracansimultaneouslyobtainboththeglucoseconsumptionrateandmorphologicalimages
oftumorswithhightissuecontrast.Inourinstitute,PET/MRIhasbeenusedfordiagnosisoftumorsinheadandneck,
pelvicorgans,andorthopedicfield.Duetoahightissuecontrast,theglucoseconsumptionrateforeachcomponentof
tumorincludingsolidandcysticcomponentsetc.canbeevaluateusingPET/MRI.PET/MRImightalsobeusefulto
evaluateeffectsoftreatments.
NotonlymorphologicalimagesbutalsoseveralkindsoffunctionalimagescanbemeasuredbyMRI,e.g.,blood
flow, oxygen consumption rate, and diffusion of water molecule. Many kinds of functional images can also be
measured by PET with various radiotracers, e.g., blood flow and energy metabolism, neurotransmission functions,
andpathologicalchanges.Thus,simultaneousmeasurementofseveralkindsoffunctionalinformationbyPET/MRI
might introduce useful information for diagnosis and evaluation of treatment. In addition, simultaneous data
acquisitionbyPETandMRImightallowreal‐timemotioncorrectioninneurologyfield.
The attenuation correction is important procedure in reconstruction of PET images to obtain quantitative
measure.InPET/MRIsystem,anattenuationmapiscalculatedfromwaterandfatimagesobtainedfrominphaseand
opposedphaseimagesofgradientechoT1‐weightedimages,anditissegmentedintofourcomponentsincludingfat,
soft tissue, lung, and air. For head, ultra‐short TE sequence is also applied to obtain skull images. The accuracy of
calculation of attenuation map is important factor for quantitative PET study, however, the cases of failure in
calculationofattenuationmapfromMRimageswerealsoreported.Suchlimitationshouldbeconsideredinuseof
PET/MRI.
S13
CE‐2‐4
TostandardizethereconstructionparametersforTimeofFlightandNon‐TimeofFlight
PET images for predicting best clinical PET scan interpretation: A Comparative study
usingNEMAIQ‐NU‐2001BodyPhantom
WattsAnkit,ChitkaraAjay,SarikaSharma,SinghBaljinder
NuclearMedicine&PETCentre,PGIMER,Chandigarh,Chandigarh
Background:TheaimofthepresentstudywastostandardizethereconstructionparametersforTOFandNon‐TOF
PETdatausingNEMAIQNU‐2001bodyphantomforpredictionofabetterclinicalimagequality.
Materials and Methods: The NEMA IQ NU‐2001 body phantom image acquisition was acquired on a Discovery
PET/CT 710 and Discovery STE 16 PET systems. The typical background volume of phantom was 9830 cc and
according to NEMA protocol amount of activity to be present at scan time was 1.5mci that corresponds to activity
concentration of 5.3kBq/cc. The hot Spheres volume was approximately 20 cc. We filled the phantom in 4:1
concentrationratiobetweenthehotspheresandthebackgroundvolume.PETdatawereacquiredin3‐dimensional
modeandwerereconstructedwiththebaselineordered‐subsetsexpectationmaximization(OSEM)algorithm,with
the OSEM+NON‐TOF (LYSO and BGO crystals) and OSEM+TOF (LYSO crystal) model. The default reconstruction
parameterforthestudywere3iterations,24subsetsandpost‐smoothingfilterof6mmwasusedinallreconstruction
models.Theimagematrixwas128*128,with5.46mmpixels.ThePETimageslicethicknesswas3.3mm.Inaphantom
study,wevariedthenumberofiterationsandnumberofsubsetsinbothreconstructionmodels.
Results:ReconstructionparametersforacquiredNEMA‐IQ‐BodyPhantomPETimageswerestandardizedforLYSO
andBGObasedPETscannersbyapplyingupto10‐iterations(OSEM‐method).TheimagequalityofreconstructedPET
images was found to be best at 2nd iteration both for TOF (LYSO) and Non‐TOF (BGO). The image quality of
reconstructedPETimageswasfoundtobebestat3rditerationforNon‐TOF(LYSO).Aqualitativeimageassessment
byTOF–providedimprovedimageresolution,definitionofsmalllesionsandimageuniformity.PETimagesobtained
byTOFwerefoundtohavehighersignaltonoiseratioascomparedtobothNon‐TOF(LYSO&BGO).TOF‐PETimages
showedhigherCRCandlowerBV(Noise)valuesforthesmallestsphere(10mm)ascomparedtoNon‐TOF(LYSO&
BGO).
Conclusion: The TOF reconstruction consistently resulted in improved image quality, resolution, image details,
uniformity and definition of small lesions. A periodic performance checking of PET scanners using NEMA
recommended–IQPETBodyphantomshouldbeemployedforpredictingthebestclinicalimageinterpretation.
S14
CE‐3‐1
Current state and future perspectives for molecular imaging and therapy of prostate
cancer;beyondtheeraofbonescanstotheranostics
SumbulZaheer,WinnieLam,WongWaiYin,AnthonyGoh,DavidNg
DepartmentofNuclearMedicineandPET,SingaporeGeneralHospital
Background:Prostatecancercausessignificantmorbidityinmenoverage50yearsandisoneoftheleadingcauses
ofcancerdeathinmenworldwide,anditisimperativetokeeppacewiththerecentrapiddevelopmentsrelatingto
prostatecancerimagingandtherapy.
Descriptionandlearningpoints:Thepresentationisaneducationalexhibitprovidingasummaryofthemostrecent
developmentsinthefieldofNuclearMedicinerelatingtomolecularimagingandtherapyofprostatecancer.
Includedarebriefdescriptionandinterestingexampleswithimagesofthelatestproceduresforprostatecancer
diagnosis,including
‐
F‐18‐Fluorocholine dual time point PET/CT imaging performed regularly in our institution and is becoming
standardofcarefordetectionofrecurrenceafterinitialtherapy
‐
Prostate specific membrane antigen (PSMA) based imaging, with both Ga‐68‐labelled ligands and F‐18 based
compounds (e.g. DCFBC and e.g. the high affinity PSMA‐avid small molecules I‐123‐MIP‐1072 and I‐123‐MIP‐
1095)
‐
Roleofthenovelamino‐acidPET/CTtracerF‐18‐FACBC(F‐18‐fluorocyclobutanecarboxylicacid)
‐
ExplorationofrenewedinterestinuseofF‐18‐NaFPET/CTforearlydetectionofbonemetastases
AlsoincludedaretherecentexcitingdevelopmentsintherapyofprostatecancerwithPSMAbasedtherapeuticagents
(e.g.Lu‐177labeledJ591)andI‐124/I‐131labeledsmallmolecule(MIP‐1095).
S15
CE‐3‐2
The experimental study on the labeling of antisense oligonucleotide from U87‐EGFRvIII
gliomacellswith188Re
LIGuiping,QIYongshuai,HUANGBaodan,DULi,ZHANGHui,HUANGKai
DepartmentofNuclearMedicine,NanfangHospital,SouthernMedicalUniversity,Guangzhou,China
Background:Gliomas,originatingfromglialcells,arethemostcommonneoplasmsaffectingthecentral nervous
system and glioblastoma multiforme is the most malignant subtype of glioma. The classical subtype of
glioblastomaisdefinedbyEGFRgeneamplification,andglioblastomasbearingEGFRamplificationsoftenexpress
EGFRvIII. This suggests that EGFRvIII may operate as critical drivers in the genesis of glioblastoma, hence
representing ideal targets for targeted anticancer therapies. The purpose of this study was to establish a
radiolabelingmethodofantisenseoligonucleotide(U2)fromU87‐EGFRvIIIgliomacellswithradionucliderhenium
(188Re)andtoinvestigatethepossibilityofusing188Re‐U2asimagingagentsforbrainglioma.
Materials and Methods: A high affinity of antisense oligonucleotide sequences U2 from U87‐EGFRvIII glioma cells
was screened by the cell systematic evolution of ligands by exponential enrichment, and was directly labeled with
188Re.Theoptimallabelingconditionandstabilityinvitrowereinvestigatedbyanorthogonalexperimentaldesign
method. Labeling rates was determined by paper chromatography. Blood radioactivity clearance of 188Re‐U2 in
rabbitswasevaluatedbydeterminingbloodradioactiveconcentrationsatdifferenttimepointafterinjectionof188Re‐
U2,anditsdynamicdistributionwasinvestigatedbySPECTimaging.
Result:Antisenseoligonucleotide(U2)wassuccessfullyradiolabeledwith 188Reandthelabelingrateof 188Re‐U2was
70%±14%. After purification of the labeled 188Re‐U2 with Sep‐PaK C18 reversed phase extraction cartridge, the
radiochemical purity was 70.6% after placing in physiological saline for 24h and 95.55% after incubation at 37°C
withhumanserum.SPECTimagingshowedthat 188Re‐U2couldbequicklyclearedfromthebloodinnormalanimals
primarilythroughthekidneys,andtheradioactivityinothertissuesandorgansremainedlow.
Conclusion: This method of directly labeling of antisense oligonucleotide (U2) with 188Re is simple with better
labeling efficiency and stability both in vitro and in vivo, and so 188Re‐U2 has more ideal biodistribution and
biokineticsinvivo.
S16
CE‐3‐3
Tumor‐selectiveparticleradiation,boronneutroncapturetherapy
Shin‐IchiMiyatake
CancerCenterandDepartmentofNeurosurgery,OsakaMedicalCollege
Boron neutron capture therapy (BNCT) in theory provides a way to selectively destroy malignant cells and
sparenormalcells.Itisbasedonthenuclearcaptureandfissionreactionsthatoccurwhenboron‐10,whichisa
nonradioactive constituent of natural elemental boron, is irradiated with low‐energy thermal neutrons to yield
highlinearenergytransfer(LET)alphaparticles(4He)andrecoilinglithium‐7(7Li)nuclei.
InorderforBNCTto
be successful, a sufficient amount of 10B must be selectively delivered to the tumor (~20 μg/g weight or ~109
atoms/cell), and enough thermal neutrons must be absorbed by them to sustain lethal damage from the 10B(n,
α)7Licapturereaction.
SincethehighLETparticleshavelimitedpathlengthsintissue(5–9μm),thedestructive
effects of these high energy particles is limited to boron containing cells.
After the accumulation of
10B‐
containing compounds into tumor cells, these cells should be irradiated by non‐hazardous low‐energy thermal
neutronsasabove.Itisnotnecessaryforustoaimonlytumorcellswithneutronirradiation.HighLETparticles
destroyonly10B‐containnigcellsandnormalsurroundingcellsarepreserved.
BNCT shows its potential, especially for the tumors infiltrating into normal tissues. Therefore most suitable
targets of BNCT might be malignant gliomas. We applied BNCT more than 160 cases of malignant brain tumors,
chiefly malignant gliomas and some high‐grade meningiomas which have the infiltrating characteristics, using
neutrons from atomic reactors. Prior to neutron irradiation, F‐labeled boronophenylalanine (BPA) positron
emissiontomographyhasbeenappliedtosimulatetheboronconcentrationintumorandnormaltissues.BPAisa
boronatedessentialaminoacidandselectivelyaccumulatesintumorcellsincomparisonwithnormalcells.Also
BPAistherapeuticcompounditselfinBNCT.Thereforetheclinicaleffectscanbeanticipatedjustpriortoneutron
irradiation by this PET. Also F‐BPA‐PET gives us very reliable clinical effects after BNCT to discriminate tumor
response and radiation necrosis.
In my talk, let me introduce our clinical results of BNCT mainly in malignant
braintumorsandsomeheadandneckcancers.
Based on these reactor‐based BNCT experiences and results for malignant brain tumors, now we and
collaboratorsareapplyingacceralator‐basedBNCTforrecurrentmalignantgliomas,asaclinicaltrialtoobtainon‐
labelusefromMHLW,sinceOctober2012.Thisaccerator‐basedBNCTenablesBNCTinhospital.
S17
OralSessions
O‐1‐1
18F‐fluorodeoxyglucose
Integrated
positronemissiontomography/contrast‐
enhanced computed tomography in the
diagnosisofPrimaryCardiacTumors
En‐taoLiu,DanShao,Shu‐xiaWang
Weilun PET Center, Department of Nuclear Medicine,
GuangdongGeneralHospital,China
Background: Primary cardiac tumors are rare, and
theimaginefeatureofpositronemissiontomography
(PET) with 18F‐fluorodeoxyglucose (18F‐FDG) is not
clearly.Theobjectivewastoinvestigatethefindingof
18F‐FDG PET/contrast‐enhanced CT (CE‐CT) in the
diagnosisofprimarycardiactumors.
Materials and Methods: 20 patients with primary
cardiac tumors underwent a conventional 18F‐FDG
PET/CT scan with low‐dose CT, and then had a full‐
dosedual‐phaseCTscan(arterialandvenousphases)
with contrast. The statistical difference between
benigntumorsandmalignanttumorswastestedbyt‐
testtoanalyzemaximumstandardizeduptakevalues
(SUVmax) and the tumor to non‐tumor ratio (TNR).
PairedttestwasusedtocomparetheSUVmaxbetween
thelessonsandnon‐tumorregion.
Results:Allcasesweresinglelesionandconfirmedby
histopathology. There was no significant difference
fortheaverageSUVmaxofnon‐tumorregionbetween
benign and malignant cases (P=0.629, t=0.492), and
between benign tumors and non‐tumor region
(P=0.281, t=－1.146). There was significant
difference of average SUVmax between malignant
tumorsandnon‐tumorregion(P=0.005,t=3.892).The
average SUVmax in malignant tumors was 6.3±3.1
versus 2.4±0.9 in benign tumors (P<0.005,
t=－3.628). The average TNR in malignant tumors
was 3.3±1.9 versus 1.1±0.3 in benign tumors
(P<0.009, t=－3.351).There was a statistically
significant difference in SUVmax and TNR between
benigntumorsandmalignanttumors.
Conclusion: Integrated 18F‐FDG PET/CE‐CT is an
effective diagnostic imaging for primary cardiac
tumors, especially in differentiating malignant from
benign lesions in patients with primary cardiac
tumors.
O‐1‐2
Differential Diagnosis of Diffuse Bone
MarrowFDGUptake
HabusariHapkido
PadjadjaranUniversity
Background: Diffuse bone marrow uptake is
frequently observed in 18F‐FDG PET/CT scan, which
S18
cancausedbymanyconditions.Theaimofthisstudy
wastodescribetheetiologyofincreasingdiffusebone
marrowFDGuptake.
Material and methods: Sixteen patients with
homogenouslyanddiffuselyincreasedFDGuptakeon
PET/CTwholebodyscanbetweenJanuary2012and
December 2013 were evaluated to find out the
etiology.
Results:Malignancywasobservedin14patientsand
benign in 2 patients. Diffuse uptake due to
hematologydisorder,chemotherapy,GCSFandextra‐
nodalnon‐hodgkinlymphomawereobservedin7,7,
1and1patientrespectively.
Conclusion: Diffuse homogenous bone marrow FDG
uptake can be seen in malignant or benign disease
andhistoryoftreatment.
O‐1‐3
FDG PET/CT total lesion glycolysis
predicts prognosis in patients with
operable
extrahepatic
biliary
adenocarcinoma
Withdrawn
O‐1‐4
18F‐FDG PET‐CT in restaging of patients
with carcinoma of tongue and
comparison with conventional imaging
modalities: A single institutional
experience
KunalKumar
AllIndiaInstituteofMedicalSciences
Materials and Methods: Data of 153 patients
(M:125) with histopathologically confirmed
carcinoma tongue who underwent FDG PET‐CT for
restagingaftercompletionoftreatmentwasanalyzed.
Result of PET‐CT was compared with conventional
imagingmodalities(CT/MRI)wheneveravailable.
Results: Sensitivity, specificity, positive and negative
predictive values for PET‐CT were 94.9%, 81.4%,
90.4% and 89.8% respectively and for CIM were
85.1%, 78.4%, 83.3% and 80.6% respectively. No
significantdifferencewasfoundbetweenPET‐CTand
CIMforlocal(P=0.454)anddistantdisease(p=0.218),
with superiority of PET‐CT for nodal metastases
(P=0.011).
Conclusion: FDG PET‐CT is highly sensitive and
specific modality for restaging of patients with
carcinoma of tongue. It performs better than CIM
especiallyforthedetectionofnodalmetastases.
O‐1‐5
Value of 18F‐FDG PET/CT in detecting
recurrentandmetastaticlesionsinpost‐
surgical
differentiated
thyroid
carcinoma patients with high serum
thyroglobulin and negative 131I whole ‐
bodyscan
LeNgocHa,BuiQuangBieu,MaiHongSon
TranHungDaoHospital
Background: In clinical practice, there were
approximately 20 – 30 % of post‐surgical
differentiated thyroid carcinoma (DTC) patients
treated with 131I therapy who had recurrent and
metastatic lesions, that could not be detected by 131I
whole‐body scan. The purpose of our study was to
evaluate value of 18F‐FDG PET/CT in patients with
highserumthyroglobulin(Tg)levelandnegative 131I
whole‐bodyscan.
MaterialsandMethods:Westudied69post‐surgical
DTC patients with high serum Tg and negative 131I
whole body scan after therapeutic doses in
Department of Nuclear Medicine, Tran Hung Dao
Hospital.
Results: 92 lesions detected in 62.3% patients with
positive 18FDG‐PET/CT scan compared to only 39
lesions in 37.7% patients detected on CT scan. The
sensitivity, accuracy and negative predictivevalue of
18F‐FDG PET/CT were 87%, 88% and 76%
respectively higher than those of CT (54.3%, 67.2%
and 48.8%, respectively). Specificity and positive
predictive value of 18F‐FDG PET/CT (90.5% and
95.2% respectively) were similar to those of CT
(95.2% and 96.2%, respectively). SUVmax threshold
with good diagnostic value were 4.5 (sensitivity
92.3%, specificity 100%). 18F‐FDG PET/CT had
alteredtreatmentplanin47.8%ofallpatients.
Conclusion: 18F‐FDGPET/CTplaysanimportantrole
in detecting recurrent, metastatic lesions in post‐
surgical differentiated thyroid carcinoma patients
withhighserumTglevelandnegative131Iwholebody
scan.
O‐1‐6
anatomical imaging (AI) to detect suspected
recurrenceinovariancancerpatients.
Materials and Methods: A retrospective study in
patientswithsuspectedrecurrenceofovariancancer
who underwent 18F‐FDG PET/CT scan in MRCCC‐SH,
betweenApril2011toApril2014.
Result: A subject with FDG (‐), but other modalities
(+).In4subjectswithFDG(+)whileAIindeterminate
&elevatedCA125serumlevel.TwosubjectswithAI
(+) & normal CA 125 serum level, the FDG (‐). In 3
subjects,FDG(+)whileAI(‐)&normalCA125serum
level.
Conclusion: 18F‐FDG PET/CT scan was useful to
detect recurrence in ovarian cancer, especially when
conventionalmethodswereindeterminate.
O‐1‐7
Detection of recurrent STS with 18F‐FDG
PET/CT:asingleinstitutionalexperience
RaviKantGupta,RidhimaB,VarunD
Background: To evaluate the utility of 18F‐FDG
PET/CT for detection of recurrent soft tissue
sarcomas(STS)aftersuccessfultreatment
Materials and Methods: PET/CT images of 45
patients (34 men) of histologically proven STS, who
hadbeenpreviouslytreatedandapparentlyinclinical
remission were included. A combination of clinico‐
radiological follow‐up, repeat PET/CT and/or biopsy
wastakenasreferencestandard.
Result: Based on reference standard, 36/55 had
recurrentdisease.Thesensitivity,specificity,positive
predictive value and negative predictive value were
75%,89.5%,93.1%,and65.3%,respectively.Second
primarymalignancywasdiagnosedin2patients.
Conclusion:PET/CTcanreliablydetectrecurrencein
patients with STS who are apparently in clinical
remission. Moreover, it has the utility to detect
secondprimarymalignancy.
O‐1‐8
Withdrawn
The discrepancy between
PET/CT scan and ca 125 & anatomical
imaginginovariancancer
PatriciaMarina
Lungs on Fire: Acute Bleomycin induced
pneumonitisonFDGPET‐CT
18F‐FDG
Background:Severalstudieshaveshownthebenefits
of 18F‐FDGPET/CTinthedetectionofovariancancer
recurrence and residual compare to conventional
methods.Theobjectivewastoshowthediscrepancies
between 18F‐FDG PET/CT scan and CA 125 &
O‐1‐9
VishalAgarwal
MedantatheMedicityhospital,India
Background:Bleomycinisachemotherapeuticagent
exerting its antitumor effect by inducing tumor cell
S19
death and inhibition of tumor angiogenesis. Its most
limitingfactorispotentiallyfatalpulmonarytoxicity,
caused by induction of free radicals. Several distinct
pulmonary syndromes are associated with it, most
commonbeinginterstitialpneumonitis.
Pathophysiology: Due to lack of the bleomycin
inactivating enzyme, Bleomycin Hydrolase in the
lungs and skin, bleomycin‐induced toxicity occurs
predominantly in these organs. The central event in
the development of BIP is endothelial damage of the
lungvasculatureduetobleomycin‐inducedcytokines
andfreeradicals.
Case: 50 year‐old man with Hodgkin's disease
presented with shortness of breath, cough and chest
pain after 4 cycles of chemotherapy, comprising
doxorubicin,bleomycin,vinblastine,anddacarbazine.
Interim PET‐CT scan was performed which showed
complete metabolic resolution of the previously
notedFDGavidnodes,whilediffuseFDGavidground
glass opacification and reticular pattern was seen in
lower lobes of bilateral lungs, predominantly in
subpleuralareas.
Conclusion: Based on intense diffuse FDG uptake in
B/L lung fields, along with clinical history and
exclusion of infective etiology, diagnosis of BIP was
made. FDG avidity is characteristic of acute
inflammatoryphasewhichcanbetreatedbysteroids
vis‐à‐vis late fibrotic stage (residual lung damage)
whichdoesn’trespond.So,FDGPETisveryusefulin
diagnosingacutephaseofBIPandhelpingindeciding
whetherornotyouaredealingwithactivedisease.
O‐1‐10
Semiautomatic Internal Tumor Volume
Segmentation for Positron Emission
Tomography Based on Background ‐ A
PhantomStudy
YangchunChen1,2XiangrongChen3,FanyongLi2,
LiuJi‐an4
1 Nuclear medicine department of Quanzhou First Hospital
of Fujian Medical University, Licheng District, Quanzhou ,
China
2 The PET‐CT Center of the first Affiliated Hospital of
GuangzhouMedicalUniversity,Guangzhou,China
3 Radiology department of of Quanzhou First Hospital of
FujianMedicalUniversity,LichengDistrict,Quanzhou,China
4 Guangdong Provincial Key Laboratory of Micro‐nano
Manufacturing Technology and Equipment, Guangdong
UniversityofTechnology,Guangzhou,China
Background: A threshold value (ThV) to outline the
internaltumorvolume(ITV)oflungcancercomputed
byaSUVinthebackgroundwasevaluated.
MaterialsandMethods:Threevacuousmodelsfilled
with 55.0 kBq/mL [18F]‐FDG representing a tumor
andfixedinabarrelfilledwith5.9kBq/mL[18F]‐FDG
representing the background served as a phantom
simulating breathing, while its PET/CT data were
acquired. The SUV in the background was X±SD.
S20
X+2SD and X+3SD were employed as ThVs to obtain
ITVs. To evaluate our methods, the Dice similarity
coefficient and volume recovery coefficient variables
were used to evaluate the accuracy of the ITVs
measuredbyeightmethodsusinganestedanalysisof
varianceandpairedt‐test.
Results: The analysis showed that these eight
methods of ITV segmentation had significantly
different results (P<0.01). Moreover, X+2SD and
X+3SD and the method of Riegel et al. surpassed the
resultsoftheotherfivepublishedmethods.
Conclusion: The ThV of the SUV determined by the
backgroundhaspotentialtodelineatetheITVoflung
cancer.
O‐2‐1
Primary brain tumor recurrence
detection: comparative study between
99mTc‐methionineand11C‐methionine
AashishGambhir,AbhinavJaimini,AmitKumar,
Sonia M Dinesh, Rajnish Sharma, Anupam
Mondal
MolecularImagingandResearchCentre,InstituteofNuclear
MedicineandAlliedSciences,NewDelhi,India
Background:UptakeofC‐11methionineandTc‐99m
methionine in brain tumor is still uncertain, but the
most theories describe combination of passive
diffusion through the damaged blood‐brain‐barrier
and carrier mediated active tumor uptake due to an
increased protein synthesis .We review our
experience of 11C methionine and 99m Tc‐methionine
indetectionofrecurrentprimarybraintumor.
Materials and Methods: 18 patients (10 males, 8
females)age30‐55years’posttherapyweresentfor
recurrence evaluation. All patients underwent C‐11
Methionine PET/CT and Tc‐99m Methionine
SPECT/CTscansontwodifferentdays.
Results: C‐11 methionine images were assessed
visually and by SUV calculation. Tc‐99m methionine
images were visually assessed and tumor to
background ratio calculated. Both were found to
show
tracer
accumulation
at
sites
of
residual/recurrenttumorinallcases.
Conclusion: Our study reveals that Tc‐99m
methioninecanbeusedasanalternativetracertoC‐
11 methionine in the evaluation of brain tumors
suspectedofresidualorrecurrence.
O‐2‐2
Imaging of gastroenteropancreatic
neuroendocrine tumors (GEP‐NETs)
using 68Ga‐DOTA‐NOC, 18F‐DOPAand 18F‐
FDGPET/CT.
AbhishekKumar
Background:Tocompare 68Ga‐DOTA‐NOC, 18F‐DOPA
and 18F‐FDG PET/CT PET radiotracers in imaging of
GEP‐NETs.
Materials and Methods: 86 patients with definite
histological diagnosis of GEP‐NET who underwent
both 68Ga‐DOTA‐NOCand 18F‐DOPAPET‐CT(groupI,
n=32)or68Ga‐DOTA‐NOCand18F‐FDGPET‐CT(group
II,n=54)wereselectedforthisretrospectivestudy.
Result:IngroupI 68Ga‐DOTA‐NOCissuperiorto 18F‐
DOPA on patient wise and region wise analysis
(P<0.0001).IngroupII68Ga‐DOTA‐NOCissuperiorto
18F‐FDG on patient‐wise analysis (P<0.0001). Region
wise, 68Ga‐DOTA‐NOCissuperiorto 18F‐FDGonlyfor
lymphnodemetastases(P<0.003).
Conclusion: 68Ga‐DOTA‐NOCseemstobesuperiorto
18F‐DOPAand18F‐FDGPET‐CTforimagingGEP‐NETs.
O‐2‐3
The Influence of P‐glycoprotein and
UlcertoTc‐99mMIBIRetentionIndexIn
LocallyAdvancedBreastCancer
AlvitaDewiSiswoyo
DepartmentofNuclearMedicineandMolecularImagingRS.
HasanSadikin/PadjajaranUniversityBandung
Background:UptakeofMIBIdependsontissueblood
flow, electrical gradient, and cellularity; its retention
wasinfluencedbyPgpexpression.Ulcerinfungating
breastcancercaninfluenceTc‐99mMIBIuptake.The
objective was to analize influence of ulcer and Pgp
expressiontoTc‐99mMIBIuptakeinLABCpatients.
MaterialsandMethods:28inoperableLABCpatients
underwent Tc‐99m MIBI dual phase scintigraphy.
Early (10 min) and delayed (240 min) planar breast
views were acquired after a 740‐925 MBq Tc‐99m
MIBI intravenous injection. Expression of Pgp was
assessedbyIHC.
Results: There were significantly different of
retention index Tc‐99m MIBI in 4 groups (group
1:ulcer‐highPgp,group2:ulcer‐lowPgp,group3:non
ulcer‐high Pgp, group 4: non ulcer‐low Pgp; (‐
0.133±0.101,
‐0.112±0.115,
‐0.27±0.057,
‐
0.225±0.087;p=0.011).Thedifferencebetweengroup
subjects with ulcer as well as non‐ulcer to subjects
Pgp expression low and high were significant,
conversely there were no significant difference of
subjects with low as well as high Pgp expression to
subjectcombinationwithulcerandnon‐ulcer.
Conclusion: Retention index of Tc‐99m MIBI in
subjects with low Pgp expression were significantly
higher than subject with high Pgp expression.
Difference Tc‐99m MIBI retention index was more
influencedbyPgpexpressionthanpresenceofulcer.
O‐2‐4
Clinical characteristics and preliminary
evaluation of empirical 131I therapy in
differentiated
thyroid
carcinoma
patients with negative 131I whole‐body
scanandelevatedserumthyroglobulin
Le Ngoc Ha, Nguyen Thi Nhung, Mai Hong Son,
BuiQuangBieu
TranHungDaoHospital
Background:Treatmentandoutcomeofdifferentiated
thyroid carcinoma (DTC) patients who had negative
131I whole body scan (WBS) and high serum
thyroglobulin(Tg)concentrationstakemuchdebateon
clinicalpractice.Theaimofourstudywastoevaluate
clinical characteristics and preliminary result of
patients with negative diagnostic 131I WBS and
increased serum Tg concentrations (during thyroid
hormonewithdrawal).
Materials and Methods: 140 DTC patients with
negativediagnostic 131IWBSandTglevel>10ng/ml
wereenrolledinthestudy.
Results: The presence of 131I uptake in post‐therapy
WBS was seen in thyroid beds 46.2 %, mediastinum
29.5%,lungs19.2 %and cervicallymphnodes 5.1%.
There was no significant difference between the
number of lesions detected in post‐therapy 131I WBS
and CT scan. However, cervical lymph nodes were
detected more frequently in CT than that of the post‐
therapy WBS. On the contrary, post‐therapy 131I WBS
can detect more lesions in thyroid beds, lungs and
mediastinum. After 12‐month empirical 131I therapy,
serum Tg levels were reduced significantly. 71% of
patientswerecompleteorpartialremission.
Conclusion: Diagnostic multi‐modalities should be
usedfordetectingresidual,recurrentandmetastatic
lesions in DTC patients with negative 131I WBS and
elevated Tg. The empirical 131I therapy may be
consideredselectedindividualsofinthesepatients.
O‐2‐5
The Changes of Keloid Volume Post‐
TherapyUsingP‐32SodiumPhosphate
HapsariIndrawati
Background: P‐32 has long been known for therapy
and has characteristics that are suitable for keloid
S21
therapy.Sofartherehasbeennorecordavailableof
changesinkeloidvolumepost‐therapywithP‐32.The
objective was to observe post‐treatment changes in
keloidvolumepostP‐32treatment.
Materials and Methods: Participants were patients
withkeloidswhoreceivedP‐32therapy.Thenumber
of lesions is determined by taking into account the
estimated value of sensitivity so that the minimum
totalsampleis100lesions.
Results: There is a significant reduction in keloids
volume2and3monthsaftertreatmentcomparedto
pre‐treatmentvolume(P<0.05).
Conclusion:Threemonthspost‐therapyisconsidered
tobethebestperiodtoassesstheresponseofkeloid
toP‐32therapy.
O‐2‐6
A Serum Predictor of Graves Disease
Recurrence
Following
Radioactive
IodineTherapy
Kosik,Russell;Tom,Andrea;Tseng,Jeffrey
Santa Clara Valley Medical Center, Department of Nuclear
Medicine,SanJose,California,USA
Background: Radioiodine therapy with 131I is the
definitive treatment for Graves disease. Although
success rates are relativelyhigh, a subset of patients
reverttoahyperthyroidstate.Inthisstudy,weseeka
serum marker that will predict the recurrence of
Gravesdiseasefollowingradioiodinetherapy.
MaterialsandMethods:Allpatientswhounderwent
radioiodinetherapy for Graves disease from 2005 to
2011 at our institution were examined. Multiple
serummarkerswerecollected.RecurrenceofGraves
diseasewasdefinedasaTSH<0.01IU/mLfollowing
therapy. 140 patients were examined, including 104
patientswhoremainedhypothyroidoreuthyroidand
36 patients who experienced a recurrence of
hyperthyroidism.
Results:Patientswhoexperiencedarecurrencewere
significantly more likely to have a greater than 1.0
IU/mL increase in serum T4 levels within two
monthspost‐therapy(36.1%versus6.7%,P<0.0001).
Conclusion: Post‐therapy serum T4 levels are good
predictorsofhyperthyroidismrecurrenceandshould
beobtainedforallpatientswhohavehadradioactive
iodinetherapy.
S22
O‐2‐7
18F‐Labeled trans‐Ferulic Acid and its
evaluationastumourimagingagent
Saikat Nandy; Avik Chakraborty; Yogita Pawar;
S.H.Moghe;M.G.R.Rajan
Radiation Medicine Centre, Tata Memorial Centre Annexe,
BhabhaAtomicResearchCentre,Parel,Mumbai,India
Background:FerulicAcidisoneofthemostcommon
and well‐known hydroxycinnamic acids (HCAs).
Evidence that HCAs may have a potential inhibitory
effect on cancer invasion and metastasis is
increasingly being reported. Development of 18F‐
labeled derivative of trans‐ferulic acid and exploring
it’spotentialastumourimagingagentbyPET.
Materials and Methods: trans‐ferulic acid is
successfullylabeledwith 18Fby[18F]Fluoroalkylation
method by a fully automated radiosynthesis
procedure and Sep Pak® cartridge purification.
PET/CTimaginginhealthyandinducedinflammation
bearing rabbit were carried out for pharmacokinetic
and tracer accumulation studies at inflammation
sites. Bio‐distribution was carried out in tumour
(B16F10) bearing mice (C57BL6) for studying
accumulationandretentionofthetracerintumour.
Results:Thenon‐decaycorrectedradiochemicalyield
is ~ 25% with >95% radiochemical purity. PET/CT
images showed complete blood, liver, gut clearance
two hours post injection but showed high tracer
accumulation in bone marrow, gall bladder,
submandibularjawsetc.Theimagesoftwohours45
min, showed complete clearance of the tracer from
kidney and accumulation in bladder with high bone
marrow uptake. The tracer does not accumulate at
theinflammationsites.Bio‐distributionstudyshowed
veryhightraceraccumulationintumour[60minpost
inj,5.53±0.65%ID/g(n=3)]andretaineduptotwo
hours[5.68±0.29%ID/g(n=3).
Conclusion:Thefavourablepharmacokineticaswell
as tumourlocalization and retention characteristics
ofthe 18F‐labeledtrans‐ferulicacidwarrantsfurther
evaluationasaPETradiotracerforimagingtumour.
O‐2‐8
In vivo tracking of polycaprolacton
micro‐/nanoparticles using positron
emission
tomography
imaging.
Preparation, fractionation and surface
modification
StephanMaus
DepartmentofNuclear Medicine, University MedicalCentre
Mainz,Germany
Background: Particles are promising tools for
imaging, targeting and delivery in tumor therapy. A
rapid manufacturing of compact particles avoiding
the use of potentially toxic solvents is desirable. The
preparation, fractionation, surface modification,
radioactive labeling and biodistribution of solid
polymericmicrospheresbasedonbiodegradablePCL
wasreported.
MaterialsandMethods:Theproductionbasedonthe
emulsification of the molten polymer in an aqueous
phase. Centrifugation was used to fractionate
particlesaccordingtosize.Thesurfacewasmodified
by aminolysis, conjugation of a chelator and labeling
with 68Ga. Animal experiments were performed to
visualize the biodistribution of the radiolabelled
particles.
Results: Particles could manufacture using a melting
method and the double‐ emulsion technique.
Fractionation by centrifugation resulted in yields of
91 %. Only particles with less than 1 µm were
modified and labeled with 68Ga obtaining
radiochemical yields of 66 ± 5 %. The animal
experiment showed that a negligible percentage of
particles which were retained in the lung capillaries.
Clearanceofparticlesfromthebloodstreamoccurred
within30‐45min.
Conclusion: The combination of size fractionation
and chemical modification via surface aminolysis
provides the opportunity for radio labeled particles
and provides further potential in view of the
conjugation of specific ligand`s to the particles that
enablesthedirectedtargetingoftumors.
O‐2‐9
Finger Dose measurement for Radiation
workeratPET/CyclotronCenter
Afshan Ashfaq1, Ahmad Qureshy, Numair
Younis,AbubakerShahidandMaqsoodAhmad2
1 Institute of Nuclear Medicine & Oncology (INMOL),
Pakistan
2 Centre for High Energy Physics, University of the Punjab,
Pakistan
Background: The US Pharmacopoeia and Good
ManufacturingPracticedescribeanumberofquality
controlteststhatshouldbeexecutedbeforerelease
of FDG for human use. The key attention is to
determine the finger dose of radiation worker
during quality control of FDG and FDG
administrationtopatients.
MaterialsandMethods:Thefingerdosesreceivedby
eight workers were measured using TLD ring
dosimeter on the right hand during routine quality
controlandpatientinjection.Atotaloftwoyearsdata
were obtained for the dispensing of the quality
control samples for pH, gas chromatography, thin
layer chromatography, endotoxin test, multi‐channel
analyzer test, Kryptofix test and high performance
liquidchromatography.
Results:Theaveragetotaldoseforthecompletionof
all tests was 19 mSv per month for quality control
procedures and 6mSv per month in patient injection
respectively. The radiation workers involved in
qualitycontrolofFDGreceived3timesmoredosesas
compared to radiation worker injecting patient. The
radiation workers received 33% of the total dose
duringPHtest.
Conclusion: Considering the finger dose these staff
membershouldberotatedmorefrequentlyfromduty
place.
O‐2‐10
To optimize OSEM image reconstruction
parameters (number of iterations and
FWHM)forWholebodyPET/CT
Akshima Sharma, A. K. Pandey, C. S. Bal, R.
Kumar
Department of Nuclear Medicine, All India Institute of
MedicalSciences,NewDelhi,India
Background:TheimagequalityofPET/CTisaffected
by various factors which include technical errors,
Biological factors, and Physical factors. The errors
due to physical factors can be reduced by using
standardized image reconstruction parameters. The
choice of reconstruction parameters is a trade‐off
betweenresolutionandnoiseandhasamajorimpact
ontheperformanceofclinicallyimportanttaskssuch
as lesion detection. Moreover, these image
reconstruction parameters are highly specific to
manufacturer and scanner type thus making
generalizationsdifficult.
Materials and Methods: PET/CT scan of Deluxe
Jaszczakphantomfilledwithwaterhaving74MBqF‐
18 FDG was acquired on Biograph mCT (Siemens
Healthcare) PET/CT scanner. PET scan was acquired
in one bed for 5 minutes. Transverse slices were
reconstructedusingOSEMreconstructionmethodby
varying FWHM from 1mm to 8 mm and for each
FWHM,iterations(IT)variedfrom1to10.Theimage
quality of 240 mages was assessed by two nuclear
medicinephysiciansbasedon4pointscale.
Results: At constant iteration, increase in FWHM
resulted in smooth images, but gradual decrease in
image quality seen because of edge blurring. At
constant FWHM, increase in number of iteration
improvedthecontrastintheimagebutatthecostof
inclusionofnoise.
Conclusion: Optimized value of iteration and FWHM
werefoundtobe4and2mmrespectively.
S23
O‐3‐1
Cardiac
mechanical
dyssynchrony
assessed by Equilibrium radionuclide
angiography (ERNA) in patients with
non‐ischemic dilated cardiomyopathy
(DCM)–PredictionofresponsetoCRT
Anirban Mukherjee, ChetanD Patel, Nitish Naik,
GautamSharma,AmbujRoy
AllIndiaInstituteofMedicalSciencesIndia
Background: ERNA plays significant role in
assessment
of
cardiac
mechanical
dyssynchrony(CMD)whichmaypredicttheresponse
to Cardiac Resynchronisation therapy (CRT). The
objective was to evaluate ERNA in prediction of
responsetoCRTinpatientswithnon‐ischemicDCM.
Materials and Methods: ERNA and clinical
evaluation was performed in 20 non‐ischemic DCM
patients (13 male, 59.6± 9.67 year) before and 3
monthsafterCRTimplantation.SDofLVmeanphase
angle(SDLVmPA)anddifferencebetweenLVandRV
mPA (LV‐RVmPA) were used to quantify left
intraventricular synchrony and interventricular
synchronyrespectively.LVEFwasalsoevaluated.
Results:Atbaseline:meanNYHAclass3.55±0.51and
meanLVEF26.95±7.2%,SDLVmPA43.8˚±20.6˚,LV‐
RVmPA23.9˚±10.5˚.At3monthfollow‐up15patients
respondedtoCRTwithimprovementinNYHAclass≥
1orEF>5%.RespondershadsignificantlyhigherSD
LVmPA 50.6˚±19.1 than nonresponders 23.4˚ ± 7.4˚
(P<0.05). ROC curve analysis showed 93.3%
sensitivityand80%specificityatacut‐offvalueof26˚
forSDLVmPAforthepredictionofresponsetoCRT.
Conclusion: Baseline for SD LVmPA assessed by
ERNAcanpredicttheresponsetoCRT.
O‐3‐2
Association of Coronary Flow Reserve
(CFR) by Dipyridamole SPECT Mibi with
Perfusion Findings and Risk factors for
CAD
DeverlyTumapon,MD,JerryObaldo,MD
PhilippineHeartCenter
Background: Blunting of CFR may precede overt
ischemia. The study aimed to correlate CFR with
perfusionfindingsandriskfactorsforCAD.
Materials and Methods: Fifty‐four consecutive
patientsunderwentdipyridamole‐restMibiSPECTon
twoseparatedays.CFRwascomputedasthequotient
of myocardial blood flow (MBF= global tissue
perfusiondividedbyarterialinputfunction)atstress
andatrest.
Results:CFRwassignificantlylowerinpatientswith
abnormal perfusion vs normals (p=0.005). Reduced
S24
CFR noted in 83% of patients with normal SPECT.
Lower CFR seen in hypertensive patients with LVH
compared to those without LVH (p=0.029); likewise
inDMvsnoDM(p=0.121).Independentpredictorsof
reducedCFRwereageandextentofischemia.
Conclusion: Abnormal perfusion is associated with
reducedCFR.Inthosewithnormalperfusion,thereis
a high prevalence of reduced CFR, which may be
attributedtothepresenceofriskfactorsforCADand
LVH.
O‐3‐3
Correlation of Perfusion and Wall
Motion
Abnormalities
on
Gated
MyocardialPerfusionScanInPatientsof
CoronaryArteryDisease
JaweriaGillani
SurayaAzeemHospital,Pakistan
Background:Purposeofstudywastofindcorrelation
between segmental perfusion defects (SPD) and wall
motiondefects(WMD)onGatedMyocardialPerfusion
SPECT(G‐MPS)inpatientsofcoronaryarterydisease
(CAD).
Material and Methods: Consenting adult patients
referredforG‐MPSforCADassessmentwereenrolled
in the study belonging both genders. Patients
underwent Two days rest‐stress study using 20‐
25mci Tc‐99m MIBI injected intravenously. Imaging
was performed at Seimens E‐cam gamma camera.
DatawasanalyzedusingsoftwareSPSSversion17.0.
Results:Of28patients,maletofemaleratiowas65%
and 35%, with 21% above 50 years. 42% had single
riskfactor,hypertensionbeinghighestand48%with
two or more risk factors. Mean LVEF on stress and
rest was 59% and 55% respectively. 20 segment
analysis was used to analyze 560 segments. Stress
showed 17%, 23%, 18.3%, 30%, 9.6% SPD and
17.9%, 24.3%, 19%, 29.6%, 10% WMD in the
anterior, inferior, septal, lateral and apical part
respectivelywithlateralwallshowinghighernumber
of abnormalities. Rest study showed 7.8%,
35.9%,20.2%20.2%,13.4%SPDand13%,33%,18%,
24%, 12% WMD in anterior, inferior, septal, lateral
and apical part respectively with inferior wall
showinghighernumberofabnormalities.
Conclusion: The study shows that Chi‐square
correlative index was calculated to be as 0.05 at the
confidence interval of 95% which is significant. CAD
producing significant SPD on stress shows similar
extentofWMDindicatingagoodcorrelationbetween
perfusion and wall motion. The discordanceof SPD
and WMD was observed in less than 5%, probably
due to cardiomyopathy, stunning and attenuation
artifacts. Thus we may conclude that G‐MPS can be
usedreliablyforevaluationofLVperfusionandwall
motion.
O‐3‐4
Diagnostic value of FDG‐PET/CT in
thoracic aortic graft, aortic root and
pulmonarystentinfection
KarinaDelMundo,MD
UniversityofSantoTomasHospital
Three case reports are presented to emphasize
the importance of 18FDG PET‐CT as part of the
initial workup of patients presenting with
suspicious stent graft infection. In these cases, the
diagnosis of infected stents‐grafts were diagnosed
initiallybasedontheabnormaluptakeinthe18FDG
PETCTscan.
Thefirstpatientisacaseofthoracicaorticgraft
infection detected by 18FDG PETCT scan. Her CT
angiography was negative for infection. The second
patient had an aortic root abscess and prosthetic
valve endocarditis as seen by abnormal uptake in
the 18FDG PETCT. Her previous echocardiography
was negative for any signs of infection. The third
patient had pulmonary artery stent infection as
suggested by the abnormal 18FDG PETCT findings.
Both her trans esophageal echocardiography and
trans thoracic echocardiogram were negative for
anysiteofinfection.
ThesecaseshighlighttheimportanceofFDGPET
CT in diagnosing stent grant infection in the
background of negative findings in other imaging
modalities.Insomecases,FDGPETCTcouldbethe
most sensitive and specific test in detecting this
condition.Itmaybeusedasaninitialandfollowup
testinselectedpatientswithstent‐graftinfection.
O‐3‐5
Comparison of biventricular ejection
fractions with cadmium‐zinc‐telluride
SPECT
and
planar
equilibrium
radionuclideangiography
Yi‐Chieh Chen, Mei‐Fang Lo, Chi‐Lun Ko, Mei‐
FangCheng
DepartmentofNuclearMedicine,NationalTaiwanUniversity
HospitalandNationalTaiwanUniversityCollegeofMedicine,
Taipei,Taiwan
Background: Radionuclide angiography provides a
simpleandnoninvasivemethodtoassessventricular
function. Gated blood‐pool SPECT (GBPS) on solid
state cadmium‐zinc‐telluride (CZT) detectors has the
potential to replace planar equilibrium radionuclide
angiography (ERNA). The Objective was to compare
the CZT SPECT with traditional planar camera for
biventricularejectionfractions(LVEFandRVEF)and
to assess the inter‐operator variation among three
differentanalyses.
MaterialsandMethods:34patientsunderwent24‐
frame gated ERNA with traditional gamma camera
and GBPS with CZT detectors. The GBPS datasets
were reframed at an LAO orientation. Both
traditional and reframed planar images were
analyzedtomeasureejectionfractions.Additionally,
theGBPSstudieswerealsoprocessedusingCedars‐
Sinai Blood‐Pool Gated SPECT software that
automaticallycalculatesLVEFandRVEF.Eachofthe
three datasets was analyzed individually by two
technologists.
Results: Comparison of LVEF from ERNA and CZT‐
reframe yielded excellent correlation coefficient of
0.984 and 0.959 by two operators. RVEF showed
poorer correlation among three analyses. The inter‐
operator reproducibility of LVEF in ERNA, CZT‐
reframe and GBPS were good (r = 0.958, 0.941 and
0.92 respectively) but poorer in the RVEF
measurements (r = 0.799, 0.668 and 0.797
respectively).
Conclusion: GBPS and CZT‐reframe provided high
inter‐operator reproducibility and correlated well
with planar ERNA in the assessment of left
ventricularfunction.
O‐3‐6
A preliminary study on Guinea Pig by
Positron Emission Tomography with
Dopamine Transporter imaging agent
18F‐FECNT
MiaoLiu1,ZhengpingChen2,XingdangLiu1*
1 Department of Nuclear Medicine，Huashan Hospital,
FudanUniversity,Shanghai,200040,China
2 The Key Laboratory of Nuclear Medicine, Ministry of
Health PRC, Jiangsu Institute of Nuclear Medicine, Wuxi,
214063,PRChina
Background: 18F‐FECNT is a potential dopamine
transporters(DAT)imagingagentforitshighaffinity
and selectivity to DAT. The aim of this study was to
investigate 18F‐FECNT distributions in guinea pig
eyes,striatum,cortexandcerebellum.
Materials and Methods: Dynamic imaging with
microPET of five tricolor guinea pigs was performed
immediatelyafterIntravenousinjectionof 18F‐FECNT
for 120mins, and two were extended to 180min. To
sketchanddrawROIandtimeactivitycurveofeyes,
striatumandcerebellumbysoftwareASIProVMTM.
Results: All subjects, aged 11 weeks, average
weighted 256.7g, received 12.0MBq (323.7μCi) 18F‐
FECNT. Drugs gathered quickly after iv in cortex,
cerebellum and striatum, declined rapidly and
remained stable at last. That in eyes continued to
increase, peaked at about 60 min, and remained
stable at a relatively high level. The drug ratio of
striatum / brain at 5,15,30,60,90,120,180 min were
respectively 1.31,2.04,2.27,2.10,1.94,1.56,1.22. And
the retina / brain ratio were respectively
0.48,1.06,1.61,2.30,2.53,2.62,2.54.
S25
Conclusion:Thisstudydemonstratedgoodaffinityof
18F‐FECNTtoDATinguineapig’sretinaandstriatum.
O‐3‐7
FDG‐PETScaninDementia
Ryan Yudistiro, Ivana Dewi Mulyanto, Rocksy
FransiscaVS,AnyeliriaSutanto,Feliana,
Nuclear Medicine Department, MRCCC Siloam Hospital
Semanggi,UniversitasPelitaHarapan
Background: Nowadays, diagnosis of dementia is
made through several clinical criteria, as in DSM IV
andPetersencriteria(specificity75%andsensitivity
31%). Thereby, a reliable and more accurate
diagnostic tool is needed. One of the promising
examinationsisFDG‐PETScan,whichhavesensitivity
as high as 78‐97% along with specificity of 74‐86%.
Purpose is to describe the characteristic of FDG PET
scanimagesindementiapatients.
Case Report: Ten cases of cognitive impairment was
reported with 4 cases suggestive of Alzheimer
dementia,2casesoffrontotemporaldementia,2cases
of mild cognitive impairment, 1 normal aging, and 1
cases of cognitive impairment in young adult with
depression. FDG‐PET Scan examination in Alzheimer
dementia cases reveals significant hypometabolism
particularly in frontotemporal and posterior cingulate
cortex.Contrastwithfrontotemporaldementiaresults
in hypometabolism of frontal, temporal, and
parietotemporal area. In mild cognitive impairment
examination, mild hypometabolism was found in
cingulate posterior and parietotemporal cortex. In
normal aging case, normal level of metabolism was
discoveredinmostofthebrainarea.Intheotherhand,
theresultofcognitiveimpairmentinyoungadultwith
depression case was hypometabolism in cingulate
posteriorandinferiorparietalcortex.
Conclusion: FDG‐PET Scan could be used as
diagnostic tool to support the diagnosis of cognitive
impairment in various levels by discovering the
specifichypometabolismareainbrain.
O‐3‐8
Tc‐99m DTPA UPTAKE IN PATIENT
WITHGRAVES’OPHTHALMOPATHY
ErwinAffandiSoeriadi
UniversitasPadjadjaran,Indonesia
Background: Differentiation active from inactive
Graves’ ophthalmopathy is very important in the
management of Graves’ ophthalmopathy. The aim of
thisstudyistodeterminethedifferencesbetweenTc‐
99m DTPA uptake in active and inactive Graves’
ophtalmopathybasedonClinicalActivityScore(CAS).
Material and Methods: Evaluation of CAS was
S26
conducted by an ophthalmologist on twenty seven
proptosis patients (54 orbits). The patients then
underwent Tc‐99m DTPA orbital scan. Statistical
analysiswasdoneusingtheMann‐Whittneymethod.
Results: In this study showed a very significant
difference in Tc‐99m DTPA orbital uptake between
active and inactive Graves’ ophthalmopathy
(P<0,002). Tc‐99m DTPA uptake was higher in the
activegroupcomparedtotheinactivegroup.
Conclusion:Tc‐99mDTPAorbitalscancanbeusedto
differentiated active and inactive Graves’
ophthalmopathy.
O‐3‐9
Value of 18F‐FDG PET/CT in assessing
prosthetic cardiac and vascular device
infections
KarinaDelMundo,NehaKwatra,ChunK.Kim
UniversityofSantoTomasHospital
BrighamWomen'sHospital,BostonChildren'sHospital
Background:Threecasesarepresentedtoemphasize
the importance of 18F‐FDG PET/CT in suspected
cardiac or vascular device infections. A literature
reviewwillalsobepresented.
Case Series: The 1st patient is a case of thoracic
aortic graft infection with a negative initial CT
angiogram.Her 18F‐FDGPET/CTscanshowedintense
focaluptakeinthegraftconsistentwithinfectionthat
wasconfirmedintra‐operatively.The2ndpatientisa
case of prosthetic valve endocarditis/abscess
diagnosed by 18F‐FDG PET/CT, who had a negative
initial echocardiogram. The 3rd patient is a case of
pulmonary artery stent infection diagnosed by
abnormalfocalFDGuptakeinthestentthatimproved
onfollow‐upPETafterantibiotictherapy.
Conclusion: 18F‐FDG PET/CT may be useful in
patientswithcardiacorvasculardevices,particularly
withnegativeorequivocalfindingsonotherimaging
modalitiesandwithahighclinicalsuspicion.
O‐3‐10
Diagnostic
Accuracy
of
Tc‐99m
Ceftizoxime in Diagnosis of Bone
Infection
MonaAbidJafri
RawalpindiInstituteofCardiology,Pakistan
Background: Ceftizoxime is a broad spectrum third
generation cephalosporin. It has been successfully
labeled with Tc‐99m and could be utilized as an
infectionimaging agent. The study was conducted to
evaluate the potential as a bone infection imaging
agent in humans and to do comparison of 99mTc‐
Ceftizoxime (99mTc‐CFT) with Magnetic Resonance
Imaging(MRI)inthediagnosisofOsteomyelitis.
Materials and Methods: We studied 40 patients (14
females,26males,meanage:25.4yrsrange;2‐59yrs)
suspected of having bone infections. All patients
underwent 3 phase MDP bone scan and 99mTc‐
Ceftizoximescan.
Results: Out of 40 patients, who underwent 99mTc‐
Ceftizoxime scan, 29 were positive for Osteomyelitis
and 11 were negative for Osteomyelitis. Sensitivity,
Specificity, Positive predictive value, Negative
predictive value and Accuracy of 99mTc‐Ceftizoxime
was100%,84.6%,93%,100%and95%respectively
and that of MRI was 100%, 50%, 91.6%,100% and
92%respectively.Semi‐quantitativeanalysisrevealed
mean T/NT ratio of (2.49 ± 0.98) at 60 minutes and
(2.48±0.97)at180minutes.Nosignificantdifference
wasfoundbetweenthemeanvaluesofT/NTratios.
Conclusion:99mTc‐Ceftizoximeishighlysensitiveand
specific agentfortheimagingboneinfections. 99mTc‐
CeftizoximeismorespecificthanMRIinthediagnosis
ofosteomyelitis.
O‐3‐11
Comparison Tc‐99m RBC Venography
withContrastPhlebographyindetecting
DVT
RynaZMartiana,ChafiedVaruna
Department of Nuclear Medicine, Pertamina Central
Hospital
Background: The diagnosis of Deep Venous
Thrombosis (DVT) in the lower limb is based on
clinicalsigns‐symptomsinconjugationwithimaging
studies. Contrast phlebography is accepted gold
standard for detecting DVT; but it is invasive and
often painful, compared with 99mTc‐RBC
Venography. The objective was to compare 99mTc‐
RBC Venography with contrast phlebography, in
detectingDVT.
MaterialsandMethods:Aretrospectivestudyon13
patients (6 males/7 females, aged 51‐68) with
suspected to have DVT. We conducted imaging with
99mTc‐RBCVenographyandcontrastphlebographyon
allpatients.
Results: 99mTc‐RBC Venography: all of the 26 lower
limbs diagnosed DVT were confirmed. Contrast
phlebography: 4 lower limbs had DVT, 20 lower
limbs had varicose veins, and 2 lower limbs were
normal.AllpatientsreceivedDVTtherapy.
Conclusion: 99mTc‐RBC Venography has the
capability to detect DVT better than contrast
phlebography.
O‐3‐12
Comparison of Methods to Measure GFR
inSouthAsianPopulation
MuhammadSohaib
PakistanInstituteofEngineeringandAppliedSciences
Scintigraphic determination of glomerular
filtrationrate(GFR)using 99mTc‐DTPAisfrequently
ordered by urologists. Method by Gates is most
commonly used despite that its inaccuracies has
beenreportedinseveraloccasions.Inthisstudywe
comparedGatesmethod(GFRGates)withaJapanese
formula by Inoue et al (GFRInoue) in healthy
Pakistani population. In phase‐I of the study GFR
values by Gates and Inoue methods in 94 healthy
potential kidney donors (25 females and 69 males)
were compared with Russell’s two plasma sample
clearance method (2‐PSC). In phase‐II 616 healthy
adults were studied for GFR using Gates and Inoue
formulae, 24‐hour creatinine clearance (GFRCrCl),
and Cockcroft‐Gault (GFRCG) methods. In phase‐I
Inoue’s method had no statistical significant
difference(pvalue0.22),goodcorrelation(R=0.69)
andleastbias(‐1.91ml/min/1.73m2,RMSE=11.85
ml/min/1.73m2) with 2‐PSC. Gates method on the
otherhandtendedtounderestimateGFRby20.90%
with bias of 25.07 ml/min/1.73m2 and RMSE of
29.97. In phase II GFRInoue had better correlation
with GFRGates (r=0.67) compared with GFRCrCl
(r=0.13) and GFRCG (r=0.08). GFRCrCl and GFRCG
had wider scatters (RMSD= 21.27 and 21.59
ml/min/1.73m2 respectively) compared with
GFRGates(RMSD=14.53ml/min/1.73m2).Allvalues
of GFR tended to underestimate when compared
with Inoue's method. Method by Inoue to measure
GFR is more accurate in normal South Asian
population.
S27
PosterPresentations
P‐1‐1
FDG PET/CT in Staging, Restaging and
Response Assessment of Ewing Sarcoma
FamilyofTumors
AmritaTiwary
Artemis,India
Background:TodeterminetheroleofFDGPET/CTin
staging,restagingandresponseassessmentofEwing’s
SarcomaFamilyofTumors(ESFT).
Materials and Methods: 37 patients of
histopathologically proven ESFT were subjected to
FDGPET/CT.Patientagerangedbetween5‐45years
withmeanageof21yrs;maletofemaleratiowas4.2:
1.Response was assessed as per PERCIST criteria by
followupPET/CTin26cases.
Results: Out of 37cases,29 cases of skeletal Ewings
sarcoma (ES)‐17spinal & 12 extra‐spinal, 4
Extraskeletal Ewings (ESE), 2 Askin`s tumor of chest
wall & 2 PNET. There were 43.2% cases of stage
IIa,2% IIb,2% III,21% IVa &29.7% IVb. SUVmax of
primary lesion ranges from 2.5 to 19.3(mean
6.1).Regionallymphnodes(57%)weremostcommon
site of metastases.Distant metastases were found in
37%, lung (21.6%) was most common site, followed
bybone(18.9%).Outof26patientstherewasCMRin
9(34.6%), PMR in 7 (26.9%), SD in 1 (3%) &PD in 9
(34.6%)casesrespectively.
Conclusion: FDG PET/CT may be helpful tool for
staging, restaging & response assessment of ESFT as
wellasforlocalizationofdistantmetastases.
P‐1‐2
18F‐FDGPET/CTimaginginpatientswith
cutaneouslymphoma
A.Mukherjee,P.Sharma,H.Singh,S.SumanKC,
R.Kumar,C.S.Bal
A.I.I.M.S,India
Background: 18F‐FDG PET/CT can play significant
role in evaluation of patients with cutaneous
lymphoma.TheObjectivewastoevaluateroleof 18F‐
FDGPET/CTinpatientsofcutaneouslymphoma.
Materials and Methods: 32 patients (52±20.5 years;
M/F‐ 22/10) underwent 50 18F‐FDG PET/CT studies
were evaluated qualitatively and semiquantitatively
(SUVmax).Histopathologywastakenasgoldstandard.
Results:31PET/CTstudieswerepositivewith93.5%
Sensitivity, 89% specificity and 92% accuracy. 27
Cutaneouslesions,17nodallesions,3spleniclesions
&1liverlesionwerenoted.Sensitivity,specificityand
accuracyofPET/CTforcutaneouslesionswere90%,
100% and 94%, and for nodal lesions were 100%,
94%, and 96%. Mean SUVmax of cutaneous lesions
S28
(5.1±2.8)&nodallesions(4.4±2.7).
Conclusion: FDG PET/CT has high sensitivity,
specificity and accuracy in patients of cutaneous
lymphoma.
P‐1‐3
Diagnostic Performance of 18F FDG PET
CT in Patients Presenting With
Secondary Neck Nodes From an
Unknown Primary Malignancy ‐ an
institutionalexperience
Manjit Sarma, Shagos G. S, S. Satish, Padma S,
ShanmugaSundaramP
DepartmentofNuclearMedicine&PETCT,AmritaInstitute
of Medical Sciences and Research Centre (Amrita Vishwa
Vidyapeetham),Cochin,Kerala,India
Background: In many patients presenting with neck
nodal metastases from an unknown primary the
primary tumor remains occult even after thorough
imaging investigations. We aimed to evaluate the
diagnostic performance of FDG PET CT in patients
with recently detected neck nodal metastases from
unknownprimary.
Materials and Method: Study included 38 patients
(male:female=30:8,agerange=32‐80years,meanage=
57.9 ± 13.39 years) with one or more palpable
cytologically/histopathologicallyconfirmedmalignant
necknode(s).AstandardprotocolforwholebodyFDG
PETCTwasfollowed.
Results: Distribution of primary tumor sites
identified by PET CT included nasopharynx in 3
patients(27.2%),tonsilsin2(18.6%),esophagusin2
(18.6%),pancreasin2(18.6%),baseofthetonguein
1(9.0%) and breast in 1 patient (9.0%). Detection
rate, sensitivity, specificity, PPV, NPV and false
positivityrateswererespectively28.9%,100%,77.7
%, 64.7%, 100% and 22.2%. FDG PET CT study also
detected other lymphnodal and organ metastases in
42%patients(16/38patients).
Conclusion: 18F‐FDGPETCTisanusefulmodalityfor
detecting unknown primary with lymph nodal
metastases in neck from an unknown primary
malignancy.
P‐1‐4
Isolated skeletal muscle metastatic
deposit in a patient with micropapillary
carcinoma thyroid identified on 18F FDG
PETCT–ACaseReport
ShanmugaSundaramP
DepartmentofNuclearMedicine&PETCT,AmritaInstitute
of Medical Sciences and Research Centre (Amrita Vishwa
Vidyapeetham),Cochin,Kerala,India
Micropapillarycarcinomaofthyroidaresaidtobe
low risk differentiated thyroid malignancy with
excellentprognosis.Wereporttheidentificationofan
isolatedFDGavidmuscledepositinatreatedcaseof
micropapillary carcinoma of right lobe and widely
invasive follicular carcinoma of left lobe thyroid
gland. Patient was found to have an elevated
thyroglobulin level with negative iodine scan (TENIS
syndrome)onfollowupat6months.An 18FFDGPET
CT (18 fluorine‐fluorodeoxyglucose positron
emission computed tomography) whole body study
wassuggested.PETCTstudyrevealedasolitaryFDG
avid deltoid muscle deposit which was
histopathologically confirmed to be metastatic
papillary carcinoma. While Follicular carcinoma is
knowntohavedistantmetastases,thisismaybethe
first reported case of solitary skeletal metastases
from micropapillary carcinoma of thyroid and
probablythesecondreportedskeletalmuscledeposit
fromDTCdetectedon 18FFDGPETCTdonefollowing
elevated thyroglobulin level and negative 131 iodine
WBscan(TENIS).Thiscasealsoassumesimportance
because it demonstrates possibility of metastases
even from a micropapillary carcinoma in contrast to
American Thyroid Association guidelines (2009)
which suggests that micropapillary carcinoma of
thyroiddoesnotmeritfurthertreatmentafteraTotal
Thyroidectomy.
P‐1‐5
F‐18 FDG PET/CT imaging in Identifying
Primary Cancer in Patients with Cancer
ofUnknownPrimary(CUP)
SMeutia,BDarmawanandHBudiawan
Background:PETisafunctionalimagingthatshows
biodistributionofF‐18FDGincancercells.Theaimof
this study was to find out the value of F‐18 FDG
PET/CTinidentifyingtheprimarytumorsinpatients
sufferingfromcancerofunknownprimary.
MaterialsandMethods:73patients(40menand33
women;meanage53years)withCUPwerereferred
toMRCCC‐SHforF‐18FDGPET/CTscan.Quantitative
SUV max ≥ 2.5 of suggested primary tumor and
qualitative analysis using pattern metastatic sites of
lymphnodeconsidertobeprimarytumorsite.
Results: 7 of 73 patients was in negative, 7 in
equivocal and 59 in primary tumor suggested
malignancy. F‐18 FDG PET/CT imaging showed
positive findings for possible location of primary
tumor; 3 in nasopharynx, 2 in oropharynx, 3 in
thyroidnodule,2inbreast,24inlung,3ingastric,4
in liver, 4 in pancreas, 1 in kidney, 3 in colon, 2 in
ovary,1inrectum,4inlymphnodeand3inbone
Conclusion: F‐18 FDG PET/CT can be used as a
biopsyguidancetodetecttheprimarytumorinCUP.
P‐1‐6
Can FDG PET/CT predict I‐131 therapy
outcome in patients with differentiated
thyroidcancer?
Sachin Jain, Ajiv Mishra, Aftab Hasan Nazar,
ChandrasekharBal
NuclearMedicine,AIIMS,NewDelhi,India
Background: To find any association between 18F
FDG avidity and radioiodine ablation/treatment
outcome in patients having differentiated thyroid
cancer
Materials and methods: We prospectively recruited
45 patients of DTC, who were referred for RIA after
either totel thyroidectomy or hemithyroidectomy
followed by completion thyroidectomy. All 45
patientsunderwentbothDxWBSand18FFDGPET/CT
scan before radioiodine therapy. RAI treatment was
donebasedontheresultofI‐131WBS.
Results: 40 patients had significant radioiodine
uptakeinDxWBSand5werenegative.18FDGPET/CT
scan was positive in 26 (57.8%) and negative in 19
patients. Twenty‐nine (64.4%) patients showed
concordant scan finding; both scans were positive in
25 and both scans were negative in 4 patients.
Regarding discordant scan findings‐ 15 patients had
positiveDxWBSbutnegative 18FDGPET/CTscanand
only 1 patient was DxWBS negative but 18FDG
positive.In15 18FDGPET/CTnegativepatients,all15
patientsachievedremissioninonedose.In25 18FDG
PET/CT positive patients, only 9 patients achieved
remission in one dose while remission in 8 patients
required more than one dose where as other 8
patients still had persistent disease. Patients with
positive FDG PET/CT scans who required more than
onedoseforremissionorstillhadpersistentdisease
hadSUVmax>4.6(p=0.001).7outof9(77.8%)patients
with positive 18FDG PET/CT who got remission in
onedosehadSUVmax<4.6.
Conclusion: FDG PET/CT could be a prognostic
markerintheinitialevaluationofpatientswithDTC.
S29
P‐1‐7
Management impact of 18F FDG PET/CT
inCarcinomaofUnknownPrimary
Withdrawn
P‐1‐8
Can we predict microvascular invasion
inHCConFDGPET‐CT?
VishalAgarwal
Background:Thepurposeofthisstudyistocorrelate
clinicopathologic and PET‐CT parameters with the
presence of microvascular invasion (MVI) at
histopathologic examination (HPE) in patients with
hepatocellularcarcinoma(HCC)whounderwentliver
transplantation.
Materials and Methods: We assessed 224 patients
with HCC undergoing liver transplantion and a pre‐
transplant PET‐CT. Three physicians (two nuclear
physicians and one radiologist) analyzed the
followingtumorparametersinconsensus:size,multi‐
focality, pattern of uptake, quantitative FDG uptake
(SUV),patternofenhancementanddistancetoclosest
vessel. The size and number of lesions, tumor
differentiation and the presence or absence of
microvascular invasion were determined at HPE and
thesefindingswereanalysedvis‐a‐vistotheimaging
parametersonPET‐CT.
Results: None of the clinical parameters was
predictive of MVI; however on uni‐variate analysis,
MVI was significantly associated with multi‐focality,
uptake pattern and distance to the closest vessel on
FDGPET‐CT.Byapplyingmultiplelogisticregression
analysis, uptake pattern (heterogeneous and
peripheral FDG uptake) was found to be the only
independentriskfactorforMVI.
Conclusion: Heterogeneous and peripheral FDG
uptake on PET‐CT was the only parameter that
correlatedsignificantlywithMVI.
P‐1‐9
Coexistenceofhepatocellularcarcinoma
(HCC) and c‐Kit positive gastrointestinal
stromaltumor(GIST):acasereport.
VishalAgarwal
Background:Apasthistoryofsporadicsolidcancers
isdisclosedin10%ofgastrointestinalstromaltumor
(GIST) patients. Simultaneous occurrence with other
malignancies is encountered in 14 to 16%, but the
S30
synchronous occurrence of GIST and hepatocellular
carcinoma (HCC) has been reported only once in the
Englishliterature.
Case: A 62‐year‐old male patient presented for
evaluationofcirrhosisandsuspectedHCCin viewof
raised AFP. On the FDG PET‐triphasic CT, done for
staging workup, a non‐FDG avid area was noted in
segment 4 which was hypervascular on the arterial
phase with a corresponding wash out. Abutting the
lesser curvature of stomach, another non‐FDG avid
exophytic polypoidal mass with heterogeneous
hypervascularenhancementwasnoted.
Results: A non FDG avid exophytic hypervascular
enhancing mass arising from the lesser curvature of
stomach was suggested to be GIST with possible
diagnostic considerations for the non FDG avid
arterialphaseenhancingfocallesioninsegmentIVof
liver included hypervascular metastatic deposit / De
novo HCC. Endoscopic/ histopathological correlation
was advised which confirmed the omental lesion to
beGISTandliverlesiontobeHCC.
Conclusion:PatientcomingforHCCstaginginwhom
a synchronous exophytic hypervascular omental
GIST,adjacenttothelessercurvatureofthestomach
was incidentally discovered, is a rare case of
simultaneous two primaries involving the GIST and
HCC.
P‐1‐10
Primary Malignant Melanoma of Vagina
onFDGPET‐CT:Arareentity
VishalAgarwal
Background: Melanoma is the most serious form of
skincancer.Somemelanomasmayalsoarisefromthe
mucosalepitheliumliningtherespiratory,alimentary
and genitourinary tracts; all of which contain
melanocytes besides the skin. These melanomas are
calledmucosalmelanomasandtheyarerare,account
for approximately 1 percent of all melanomas. An
estimated20%ofmucosalmelanomasaremultifocal,
compared with less than 5% of those arising in the
skin, and approximately 40% of mucosal melanomas
are amelanotic, compared with less than 10% of
cutaneous melanomas. Melanomas arising from the
female urogenital tract occur primarily in the vulva
andvagina.
Case: A 65‐year‐old woman presented with vaginal
dischargeforpast1yearandvaginalbleedingforpast
1 month. On examination, a cauliflower like growth
was noted arising from the lateral wall. Patient was
referred for local MR and whole body PET‐CT
scanning.
Results: WB FDG PET‐CT examination revealed FDG
avidlocalizedgrowtharisingfromtheanteriorwallin
the upper vagina, with defined fat planes with
adjacent structures. On biopsy and IHC staining,
malignant melanoma was confirmed as it was
negative for cytokeratin and positive for S‐100 and
HMB‐45.
Conclusion: Primary malignant melanoma of the
vagina is an aggressive and extremely rare
malignancy with worse prognosis than those arising
from cutaneous sites. This is probably the first
reported case of primary vaginal malignant
melanomaonFDGPET‐CTimaging.
P‐1‐11
Solitary metastatic focus in parotid on
FDGPET‐CTintreatedpatientofurinary
bladdercancer
VishalAgarwal
Background: Bladder cancer usually spreads via the
lymphatic and hematogenous routes, the most
commonsitesofmetastasesbeingtheregionallymph
nodes, liver, lung, bone, peritoneum, pleura, kidney,
adrenalglandandintestines.
Materials and Methods: The lymph node drainage
from the superior part of the bladder passes to the
external iliac lymph nodes, and those from the
inferior part of the bladder pass to the internal iliac
nodes. Some lymphatic vessels from the neck region
of the bladder drain into the sacral or common iliac
lymph nodes. In a report of 107 patients, the most
common site of metastasis of UBC was the regional
lymph nodes (78%) followed by liver (38%), lung
(36%), bone (27%), adrenal gland (21%), and
intestine(13%).Metastasestotheheadandneckarea
occur in very low rate, according to a retrospective
autopsystudy.Hessanetal.retrospectivelyreviewed
845casesofurogenitaltracttumorsformetastasesto
the head and neck area and only 3 cases had
metastasiswithUBCinorigin.
Conclusions: To the best of author's knowledge, this
is the first reported case of UBC with parotid gland
metastases,thattoosolitary.
P‐1‐12
Cholangiocarcinoma with metastases to
breast:Rarerthantherareentity
VishalAgarwal
Background: With over 1 million new cases in the
world each year, breast cancer is the most common
malignancy in women, and accounts for 18% of all
female cancers. However, metastatic involvement of
the breast is relatively rare, most common causes
being contralateral breast cancer, malignant
melanoma, lymphoma and lung cancer. Autopsy
reportsindicateanincidenceof1.7%to6.6%fornon‐
primarybreastmalignancy.
Case:Wepresentayoungfemaleofage35yearswith
a liver mass and altered liver function tests. On FDG
PET‐CT examination, FDG avid heterogeneously
enhancing irregular lesion was noted in the right
breastwithanotherFDGavidperipherallyenhancing
rounded lesion in the left breast. Liver showed a
peripherally enhancing FDG avid SOL in segment V,
VIII and IV, with ill‐defined margins and irregular
peripheralenhancement&lobularoutline.
Results: In view of hypermetabolic heterogeneously
enhancing lesions in B/L breasts and FDG avid
peripherally enhancing SOL in liver, diagnoses of
metastatic Ca. breast was suggested and pathologic
correlationwasadvised.However,HPEofrightbreast
lesionconfirmedittobemetastaticcarcinomarather
thantheprimaryofbreast.
Conclusion: Cholangiocarcinoma is a slow growing
rare,malignanttumorofthebileduct,accountingfor
lessthan1%ofallcancers.Mostly,itspreads locally
viathelymphaticstoregionallymphnodes.Metastatic
focus in the breast is a very rare presentation, this
beingprobablythefirstreportedcase.
P‐1‐13
18F
FDG Kinetics In Tuberculosis And
Lung Carcinoma And Dual Time Point
Imaging:AProspectiveAnalysis
V.Vijayant
Department of Nuclear Medicine, Rajiv Gandhi Cancer
Institute&ResearchCentre,Delhi,India
Background: It is hypothesized that various cell
types exhibit varying rates of glucose uptake and
metabolism and its measurement at any two time
points may prove to be helpful in differentiating
between infective and malignant lesions. The
objective was to evaluate the kinetics of 18F FDG
PET/CT in pulmonary tuberculosis and malignant
lunglesionswithanaimforcharacterizationinthis
prospectivestudy,utilizingwholebodyPETCTwith
dualtimepointimaging.
Materials and Methods: Sixty nine patients with
primaryneoplasticorinfectivepulmonaryandextra
pulmonary pathologies were included in the study.
37 were proved case of tuberculosis, whereas 32
were of proved case of carcinoma lung. Standard
whole body PET acquisition and delayed regional
imaging (at 3 hours) protocols were used. The
percentage (%) change in SUVmax and mean + SD
werecalculatedinbothgroupsofpatients.
Results: Evaluation of initial scans: There is
statisticallysignificantdifferencebetweenSUVmaxof
benign and malignant lesions. For pulmonary
lesions P=0.00025 and for extra pulmonary lesions
P=0.04. Evaluation of delayed scans: There is
S31
statisticallysignificantdifferencebetweenSUVmaxof
benignandmalignantlesionsfordelayedscansalso.
For pulmonary lesions P=0.00027 and for extra
pulmonarylesionsP=0.03.Itwasseenthatinfective
and malignant pulmonary lesions have statistically
significant difference in SUVmax irrespective of the
time point as compared to extrapulmonary lesions
which did not show statistically significant
difference.
Conclusion: The malignant pulmonary lesions have
higher metabolism with different CT imaging
patterns as compared to the pulmonary
tuberculosis. However extra pulmonary lesions do
not show such statistically significant difference.
There is no clinically significant additional
information in the dual time point images either in
pulmonaryorextrapulmonarylesionsandcanthus
beavoided.
P‐1‐14
Delineationofgrosstumorvolumebased
on PET images by a numerical
approximationscheme
YangchunChen1,2XiangrongChen3FanyongLi 2,
LiuJi‐an4
1.NuclearmedicinedepartmentofQuanzhouFirstHospital
ofFujianMedicalUniversity,Quanzhou,China
2. The PET‐CT Center of the first Affiliated Hospital of
GuangzhouMedicalUniversity,Guangzhou,China
3. Radiology department of of Quanzhou First Hospital of
FujianMedicalUniversity,Quanzhou,China
4. Guangdong Provincial Key Laboratory of Micro‐nano
Manufacturing Technology and Equipment, Guangdong
UniversityofTechnology,Guangzhou,China
Background: A scheme, named SUV_Shape, for the
tumordelineationwasevaluatedinthisstudy.
Materials and Methods: Seven vacuous plastic balls
filledwith[18F]‐FDGsolutionastumorwereacquired
byaPET/CT.Thevolumeofeachballwasmeasured
by SUV_Shape and a balance, labeled as GTVs and
GTVt. Five rabbits implanted VX2 tumors were
acquired by [18F]‐FDG PET/CT. These rabbits were
mercykilledwithin24hafteracquisition.VX2tumors’
volumes were measured by SUV_Shape, and caliper,
labeledasGTVsandGTVt.Thecorrelationcoefficient
betweenGTVsandGTVtweredone.
Results: The volume of each ball confirmed by the
balance was 0.56, 1.26, 5.88, 11.74, 21.30, 64.56,
179.50mL.TwelveVX2tumorsweremeasured;their
GTVt ranged from 0.11mL to 29.26mL. The
Spearman’s rho between GTVt and GTVs were 0.96
and 0.89 for phantom and animal tumor models,
respectively.
Conclusions: The SUV_Shape could delineate tumors
basedontheirradiopharmaceutical‐avidPETimages.
S32
P‐1‐15
Analysis of Standardized Uptake Values
of 18F‐FDG PET in relation to histology
tumor differentiation in esophageal
carcinoma
Yasir Majeed, A. Hassan, A. A. Syed, A. Murtaza,
Q.Khan,A.Kazmi,A.Loya
Shaukat Khanum Memorial Cancer Hospital and Research
CenterLahore,Pakistan
Background: Quantitative measurement of glucose
metabolism using standardized uptake value (SUV)
has prognostic relevance in several tumors. The
objective was to evaluate for correlation between
esophageal cancer histopathology and the F‐18 FDG
SUVonPET/CTscan.
Materials and Methods: Retrospective analysis of
284baselinescansover55months(September2009
–July2014).(59%malesand41%females,meanage
52.6years).
Results: 214 were squamous cell carcinomas (SCCa)
and70adenocarcinomas.OfSCCa,16%werepoorly,
71%moderatelyand14%werewelldifferentiated.Of
adenocarcinomas, 21% were poorly, 49%
moderately, and 31% were well differentiated. Mean
SUVmax for SCCa was 12.6 + 5.14 and 10.5 + 6.2 for
adenocarcinomas. Mean SUVmax of SCCa was 12.6 +
5.14and10.5+6.2foradenocarcinomas.
In bivariate analysis, being a female was associated
with a higher primary lesion SUV by 1.66 units
(p=0.011) compared to male. Adenocarcinomas
showed a lower SUV by 2.14 units (p=0.004)
compared to SCCa. There was no significant
correlation between the T stage and primary tumor
SUVmax (p=0.339). Multivariate analyses showed no
association of the primary tumor SUV with age,
gender, histopathology or degree of differentiation.
Also no correlation existed between the esophageal
lesionSUVmaxandactivitylevelofmetastaticfoci.
Conclusion: We found no association between the
SUVmax and histopathology or degree of
differentiationoftheprimaryesophagealcancer.
P‐1‐16
Post Radiation Tumor Recurrence
Comparative Evaluation in Gliomas on
MrAnd11C‐MethioninePET/CT
Abhinav Jaimini, Maria M D'Souza, Aashish
Gambhir, Vivek M James, Rajnish Sharma,
AnupamMondal
Institute Of Nuclear Medicine and Allied Sciences (INMAS)
Brig.SKMajumdarRoad,Delhi,India
Background: Radiation necrosis creates significant
diagnostic dilemma in brain tumor recurrence. We
compared the diagnostic performance of novel MR
techniques and 11C‐methionine PET/CT to
differentiate tumor recurrence from post‐radiation
changes.
Materialsand Methods: 20patients(age37‐80yrs)
suspected to have recurrent tumor or radiation‐
inducednecrosiswereevaluatedover24months.All
patients underwent conventional sequences (T1, T2,
Flair), MRS and T2 MR Perfusion study. 11C‐
Methionine PET/CT was performed. Histopathology
and follow‐up were used as indicators to establish
lesionidentity.
Results: 12 patients had recurrent/residual disease
and 8 had post‐treatment change. The overall
sensitivity and specificity on MR was 90.6% and
86.2%respectively.Thesensitivityandspecificityon
PET/CTwas100%and72.1%.
Conclusion: 11C‐methionine PET/CT has a higher
sensitivity;howeverMRIappearstobemorespecific.
P‐1‐17
Can Ultrasound Predict Malignancy in
PatientWithThyroidColdNodule?
lesiondemonstratedonbonescan.
Materials and Methods: Ten orbital lesions on bone
scanwerefollowedup,evaluatedandcomparedwithCT.
Results: Compared with bone scans taken 6‐49
months later, 6 lesions remained stable, 3 had
decreased uptake and 1 progressed. So, 9 lesions
were considered benign, 6 of which showed ground‐
glass density on CT indicating benign fibro‐osseous
lesions,3wasnormalonCT.
Conclusion:Mostsolitaryorbitallesionsdetectedon
bonescanarebenignandfibro‐osseouslesionsmight
bethecauseofuptake.
P‐1‐19
Detectionofoccultlesionsandavoidance
of unnecessary 131I therapy using 131I
SPECT/CT along with planar 131I whole‐
body scans in the management of post‐
thyroidectomy differentiated thyroid
cancerpatients
JWiyanto,AHSKartamihardjaandTNugrahadi
Manas Kumar Sahoo, Varun singh Dhull,
ChandraSekharBal
AllIndiaInstituteofMedicalSciences,NewDelhi,India
Background: Thyroid cold nodule with malignant
lesions can discovered using ultrasound parameters.
The aim of this study was to assess ultrasound as
supporting modality for thyroid scintigraphy to
predict malignancy in patient with thyroid cold
nodules.
Materials and Methods: A retrospective study was
done with 19 patients with thyroid cold nodule.
Ultrasoundandhistopathologywereperformedinall
subject.
Results:Papillarythyroidcarcinomawasobservedin
all 19 subjects with thyroid cold nodules based on
histopathology. Ultrasound showed malignancy only
in 8 (42.11%), while the rest 11 (57.89%) subject
werebenign.
Conclusions: Ultrasound has no role in predicting
malignancyinpatientwiththyroidcoldnodules,since
the typical appearance of malignancy on ultrasound
doesnotalwaysshowuponamalignancy.
Background:Roleof 131IWholebodyscaninthyroid
cancer management is well documented. The
limitationandfalsepositivedetectioninthismodality
can be overcome with the advanced technogy of
SPECT/CT. The objective was to evaluate the role of
131I
Single
photon
emission
computed
tomography/computed tomography (SPECT /CT) in
differentiated thyroid cancer (DTC) patients and to
evaluate the additional contribution of SPECT/CT in
patientmanagement.
Materials and methods: 625 consecutive DTC
patients referred for 131I therapy were studied. 131 I
WBS was performed approximately 24 hours after
1.5‐2 mCi 131I administration in all patients .131I
SPECT/CT was performed In 218 (80 males, 138
females)ofDTC(185papillaryand33follicular)with
medianage37years(11‐72).
Results: Planar 131 I WBS showed 245 lesions of
abnormal increased radioiodine uptake in those 218
patients who underwent SPECT/CT. SPECT/CT
revealed320lesions,(outoftotal352lesionsfromall
modalities). All lesions seen on planar imaging are
also noted on SPECT/CT along with 85 (24.1%)
additional occult lesions in 72(33%) patients.
SPECT/CT over the planar WBS could restage in 36
(16.5%) patients, determined for higher dose
administrationin69(31.6%),preventedfromhigher
dose administration in 105 (48.2%) and same
treatmentin44(20.2%)patients.
Conclusion: 131I SPECT/CT was found to be superior
in detecting occult lesions and preventing needless
131I therapy thus suggesting it to be the the most
appropriateimagingmodalityinmanagementofDTC.
P‐1‐18
Most solitary orbital lesions on Tc‐99m
MDPbonescanarebenign
LeSong,WeifangZhang,YanyanZhang
PekingUniversityThirdHospital
Background: Solitary orbital lesion on bone scan is
not uncommon but difficult to diagnosis. The
objective was to characterize the solitary orbital
S33
P‐1‐20
InsularCellCarcinomaoftheThyroid:A
RetrospectiveAnalysisof42Cases
Sreekumar.A.V.M.Pradeep.PaulSebastian.
RegionalCancerCentre.Trivandrum,India
Background: Insular cell carcinoma or poorly
differentiated carcinoma of the thyroid is a new
subtype of thyroid carcinomas. The classification of
insular cell carcinoma comes in between well
differentiated thyroid carcinoma and anaplastic
carcinoma thyroid, with respect to both cell
differentiation and clinical behavior. The objective
was to retrospectively analyze the clinical
presentation, treatment and outcome of insular cell
carcinomaofthethyroid,registeredinourcenter.
Materials and Methods: All cases of insular cell
carcinoma thyroid were retrospectively analyzed for
the following parameters: ‐age, sex, tumor size,
presenceorabsenceofdistantmetastases,treatment
givenandoutcome.
Results: A total number of 42 cases were
retrospectively analyzed from1997.There were 33
femalesand9males.Atpresentation,13patientshad
tumor restricted only to the thyroid, 20 had lymph
node metastases and 9 had distant metastases.34
patientswereeligibleforsurgery.PostoperativelyI‐
131scanshoweduptakeintheneckin28casesand
neckandmetastaticsitesin3cases.ThedoseofI‐131
varied from 100 to 250mci.Follow up varied from 6
months to 10 years.12 patients had recurrence.7
patients had local recurrence and 5 patients had
recurrenceatdistantsites
Conclusion: Insular cell carcinoma thyroid is an
aggressive tumor that is classified in between well‐
differentiated and anaplastic tumors. In our series
majority [33/42] of the patients were females.
Unlikeanaplasticcarcinomamajorityofthepatients
[28/42]showedI‐131concentration.Theminimum
dose of I‐131 given in our center was 100mCi for
residual thyroid ablation and maximum dose given
was250mci[forbonemetastases].Thesetumorsare
alsoTSHdependent,sothyroxinshouldbegivento
suppressTSH<0.01microIu/ml.Thosepatientswho
developed recurrence invariably had poor
prognosis.
P‐1‐21
68Ga‐DOTANOC
PET/CT in patients with
pancreatic neuroendocrine tumors:
singleinstitutionalexperience
SumeetSureshMalapure
AllIndiaInstituteofMedicalSciences,NewDelhi,India
Background: To evaluate the diagnostic accuracy of
68Ga‐DOTANOC PET/CT imaging in a large exclusive
S34
population of pancreatic neuroendocrine tumors
(NETs).
Materials and Methods: 141 (Mean age: 46.2±15.2
years)patientswhounderwent178PET/CTstudies
fordiagnosisandstaging(n=30),staging(n=58)and
restaging (n=90) of pancreatic NET were
retrospectively analyzed. PET/CT results were
compared to conventional imaging (CIM) when
available (n=86). HPE and/or clinical/imaging
follow up (min‐6 months) were used as reference
standard.
Results: Overall sensitivity, specificity and accuracy
of PET/CT were 85.7%, 79.1% and 84.8%. The
correspondingvalueswere73%,50%and70.4%for
diagnosis/staging groups and 98.6%, 100% and
98.8% for restaging groups. The accuracy was
significantly higher for restaging as compared to
diagnosis/staging (P<0.0001) and in non‐insulinoma
tumors than insulinomas (P<0.0001). The SUVmax of
primary tumors was significantly higher than
metastatic lesions overall (P=0.001), as well as in
diagnosis/staging
(P=0.041)
and
restaging
(P=0.0003)sub‐groups.Whenavailable,CIM wasless
specific than PET/CT (P<0.001) and showed fewer
lesions.
Conclusions: 68Ga‐DOTANOC PET/CT is useful for
diagnosis/staging and restaging of patients with
pancreatic NET. It demonstrates more lesions
comparedtoCIMandismorespecific.
P‐1‐22
68Ga‐DOTANOC
PET‐CT for restaging
gastrointestinal neuroendocrine tumors
afterprimarytreatment
VarunSinghDhull
Background: To evaluate the utility of 68Ga‐
DOTANOC PET‐CT for restaging in patients of
gastrointestinal neuroendocrine tumors after
treatment.
Materials and Methods: 89 patients with
histopathological diagnosis of gastrointestinal
neuroendocrine tumors (foregut‐23, midgut‐56,
hindgut‐10) who underwent treatment were
included. To validate the results, histopathological
correlation/conventional radiologic imaging and
clinical follow up were considered as the reference
standard.
Results:Basedonreferencestandard63patientshad
disease and 26 patients were disease free. PET‐CT
waspositivein62patients(TP‐58,FP‐4)andnegative
in 27 patients (TN‐22, FN‐5). Sensitivity, specificity,
positiveandnegativepredictivevalueswere92.06%,
84.62%, 93.55%, and 81.48% respectively. The
accuracyofthestudywas89.88%.
Conclusion: 68Ga‐DOTANOC PET‐CT is highly
efficaciousinrestagingpatientswithgastrointestinal
neuroendocrine tumors. It appears to be promising
for assessing the disease burden in this group of
patients.
P‐1‐23
99mTc
MAA SPECT/CT Quantification of
Lung Mass and Liver‐to‐Lung Shunting
Priorto90YRadioembolization
ButchMaulionMagsombol
SingaporeGeneralHospital
Background: Applying the MIRD assumption of a
1000g lung mass it is estimated that 3.0 GBq of 90Y
SIR‐spheresinapatientwith20%meanliver‐to‐lung
shunt ratio will receive a mean lung dose of
approximately30Gy.Theobjectivewastoassessthe
variability in the patient‐specific lung mass of our
patients going for 90Y radioembolization. To assess
thedifferencesbetweentheliver‐to‐lungratios(LLR)
estimatedbyplanarscintigraphyandSPECT/CT.
Material and Methods: Seventy five patients
underwent hepatic angiogram and 99mTc MAA
injection for assessment of hepatic vasculature and
dosimetry. Planar and SPECT/CT images were
obtainedtoderivetheLLR.Specificlungmasseswere
derivedfromCTmorphometry.
Results: Planar scintigraphy slightly overestimated
theSPECT/CTLLRbyanaverageof2.09%.Themean
lung mass in our patient population is 690g (726.3g
for males, 564.9g for females) therefore the MIRD
lung mass overestimates the mean lung mass by
310g.
Conclusion: Lung morphometry derived from
SPECT/CT data achieves patient‐specific dosimetry
forsaferradioembolization.
P‐1‐24
Therapy Dose Calculation in Graves
Disease Using 4‐Hour I‐131 Uptake
Measurements:ARetrospectiveStudy
CarlaMariM.Macaisa
UniversityofSantoTomasHospital,Manila,PH
Background: Twenty‐four‐hour RAIU is commonly
used to compute for therapy dose in Graves disease
(GD).Theobjectivewastodeterminethefeasibilityof
using4‐hrRAIUincalculatingthedosebycorrelating
4‐hr with 24‐hr RAIU and comparing the actual
therapy dose using 24‐hr RAIU with the computed
doseusing4‐hrRAIU.
Materials and Methods: A total of 103 GD patients
(67% F, 33% M; 18‐60 y/o), who underwent RAI
therapy at USTH (Jan 2011 to Jul 2013) were
included.Doseusing4‐hrRAIUwascalculated.
Results:Therewasastrongcorrelationbetween4‐hr
and 24‐hr RAIU values (r=0.736). Paired t‐test
showed no statistical difference between the actual
therapydosebasedon24‐hrRAIUandthecomputed
doseusing4‐hrRAIUin140‐160μCi/g.
Conclusion: Therapy dose calculation using 4‐hr
RAIU in 140‐160 μCi/g can be achieved in Filipino
patientswithGravesdisease.
P‐1‐25
Effectiveness dose of I‐131 Fixed Dose
for
Hypertyroidism
(Bandung
Experience)
KP Kusumahstuti, AHS Kartamihardja, T
Nugrahadi
PadjajaranUniversity
Background: Dose of 131I for hyperthyroidism
treatmentisstillcontroversy.Thedoseof 131Icanbe
givenfixeddosebasedonempiricalexperienceoruse
calculated dose. The objective was to compare the
effectiveoffixeddosewithcalculateddose.
Material and Methods: Retrospective study was
doneto46patientswithhyperthyroidism.Fixeddose
of 131Iis8mCi,and<8mCiand>8mCiconsideras
calculated dose. Following up was done in 3 and 6
months.
Results:Euthyroidwasobservedin3monthson72%
ofpatientusing8mCi,4%with<8mCi,and9%with
>8mCi.Euthyroidobservedin83%using8mCiin6
monthsand13%usingcalculateddose.
Conclusion: Fixed dose of 131I more effective for
hyperthyroidism treatment compare to calculated
dose.
P‐1‐26
Which form of I‐131 is precious for
thyroid carcinoma patient, either liquid
orcapsule.Mathematicalevaluation
Om Prakash*, R. Tiwari, S.rach, N.patel, V.patel,
N.Sakhia,V.bhatt,R.K.vyas.
Gujrat cancer & research institute, new civil , ahmedabad ,
Gujrat,India
Background: Capsule & liquid radioiodine (I‐131) is
routinely used in treatment of differentiated thyroid
carcinoma. In thyroid tissue it accumulates 17‐25
timesmorethantheotherpartsofthebody.Itexerts
cytotoxiceffectonthyroidtissuebybetaemission.I‐
131isanisotopeofI‐127whichisabetaandgamma
emitter. Its maximum beta energy is 0.61 Mev and
average energy is 0.192 Mev. It is a byproduct of
uraniumandplutoniumfission.
The objective of this study was to compare the
S35
ablation rate and side effect with high dose
radioiodine(I‐131)capsule&liquidformulation.
Materials and Methods: All the capsules and liquid
radio iodine procured from BRIT, bhabha atomic
researchcentre,Mumbai.Allthepatientsfastedforat
least8hrsorovernightbeforethedoseand1hrafter.
Morethan300patientsincludedinthisstudy.Before
large dose therapy diagnostic imaging of all patient
done,thentherapeuticdoseadministeredandsharply
put under observation. what type of complain they
aremakingwerenoted.
Results: The liquid form of I‐131 absorbed from
stomach within 15‐30 min, but capsules dissolve
slowlyandshapemaintainedupto2hrs.duetoslow
absorption rate mucosal lining of stomach get very
high radiation dose from 100 mCi, the dose to
stomach wall was approx 448 rad or 4.48 Gy per
hour. On the other side liquid I‐131 delivered very
less dose to stomach. Common complaint from both
type (liquid & capsule) was nausea, vomiting, neck
pain and abdominal pain. But in our observation we
found that those pts. Who have got capsule were
complaining more abdominal pain.So I have
calculated the dose to stomach from capsule which
was approx.6‐10 Gy to stomach. Due to radiation
injury mucosa lining damage occurs. This was the
reasonforcapsulepatient’sabdominalpain.
Conclusion: This quantification & dosimetric
evaluation is pointing that liquid I‐131 is better for
patients.Quickabsorptionandlessdosetoabdomen.
Solessgastralgiacomplain.Butliquidhandlingneeds
extra care and more radiation exposure to
occupationalworker.Onothersidecapsuleissafeto
handle,lessoccupationworkerexposure.
P‐1‐27
Super absorber; New approaches in
177mLuhospitalwastemanagement
StephanMaus
Mainz,Germany
Background:Treatmentswith 177Lu‐DOTATATEcould
result, dependingontheproductionrouteof theused
177Lu, in impurities of 177mLu (t1/2= 160 d) which
preventsthetimelyreleaseofthewaste.Theaimofour
studywasthedevelopmentaconversionmethodofthe
liquid wastes into gel resulting in the possibility of
disposaloverthenationalcollectionpoint.
Materials and Methods: We studied 3 patients
regarding there excreta and the absorption behavior
of the super‐absorbers for water, NaCl and urine as
wellasthestoragebehaviorforaperiodof3months.
Results: The precipitated volume of 2.42 ± 0.18 L
contained 74 ±2.2 % (5602 ± 166 MBq) of the
administered activity. An accumulation of 10 GBq
177Lu and 12 MBq 177mLu at after 40 days was
calculated. The absorber‐volume ratio for water of
0.013andforNaCl/urineof0.02wasestimated.No
S36
changesinthepropertiesorreleaseofactivitycould
beobserved.
Conclusion:Theconversionfromliquidtosolidform
usingasuperabsorberguaranteedansaverhandling,
storing at smaller space, uncomplicated collecting,
shipping and deposition for decay and financial
savings>30.000€peryear.
P‐1‐28
FullyautomatedRadiosynthesisofnovel
[18F]‐FluoroethylatedJuglonederivative
and its feasibility study as tumour
imagingagent
Nandy, Saikat1; Chakarborthy, Avik1; Pawar,
Yogita1; Moghe, S.H.1; Ghosh , Sandipto2.;
Chaudhary,P.R.2;Rajan,M.G.R.1
1RadiationMedicineCentre,TataMemorialCentreAnnexe,
BhabhaAtomicResearchCentre,Parel,Mumbai,India
2 Advanced Centre for Treatment, Research and Education
in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi
Mumbai,India
Background: Quinones have been extensively
investigated for their potential as anticancer
compounds.Juglone(5‐hydroxy‐1,4‐naphthoquinone)
is one such naphthoquinone which has exhibited the
potential of inhibition of growth of various types of
carcinomas. The objective was to develop 18F‐labeled
derivative of Juglone and exploring it’s potential as
tumourimagingagentbyPET.
Materials and Methods: [18F]‐Fluoroethylated
derivative of Jugloneis developed by [18F]‐
Fluoroalkylation method by a fully automated
radiosynthesis procedure and Sep Pak® purification.
Pharmacokineticaswellastraceruptakestudyatthe
inflammation sites were carried out by PET/CT
imaginginhealthyandinducedinflammationbearing
rabbit model. Bio‐distribution as well as micro‐
PET/CT imaging study were carried out in tumour
(B16F10)bearingmice(C57BL6).
Results:Thenon‐decaycorrectedradiochemicalyield
is ~ 15% with >95% radiochemical and chemical
purity. PET/CT images of rabbit showed very fast
blood as well as liver clearance but tracer
accumulationinhighlyproliferatingregionslikebone
marrow,guts,submandibularjawswithoutanybrain
uptake. The tracer does not accumulate at the
inflammation sites. The tracer showed high
accumulation in tumours (60 min post inj) and
retained upto two hours as confirmed by bio‐
distributionaswellasmicro‐PETimagingstudies.
Conclusion:JugloneissuccessfullylabelledwithF‐18
by [18F]‐Fluoroalkylation method. The favourable
pharmacokinetics as well as the localization and
retentionof[18F]‐FluroethylatedJuglonederivativein
tumours suggests further evaluation as a promising
PETimagingagentfordetectingtumours.
P‐1‐29
Validation of the EZAG Modular‐Lab
Pharm Tracer module processed
preparation of Ga‐68 DOTA peptides for
routine clinical application using the
iThembaLABSGe‐68/Ga‐68generator
StephanMaus
Mainz,Germany
Background: With a view for the production of
radiopharmaceutical existing GMP requirements and
the reduction of the radiation exposure for the
employees, radiolabeling of somatostatin analogues
with 68Ga or 177Lu using robotically cassette systems
are object of intense investigations. We describe the
Modular‐Lab Pharm Tracer module processed
preparation of 68Ga‐DOTATOC using the SnO2‐based
iThembaLABS68Ge/68Gagenerator.
MaterialsandMethods:Thegenerator(50mCi)was
eluted with 0.6 mol/L HCl. Elution efficiency was
expressed as the 68Ga activity at time of elution,
expressed as percentage of the 68Ge activity on the
generator column. 68Ge content was measured using
gamma spectrometry. Endotoxin testing was
performedusingtheEndosafePTS.
Results: The synthesis of 68Ga‐DOTATOC resulted in
radiochemical yields of 80% (d.c) and purities of
>98%byheating33.3mg(23,42µmoL)peptideatpH
3.5–4.0for5minat95C°in1.5ml0.6moLHCl.The
Sep‐Pak C18 cartridge was implemented as a “safety
net system”. This eliminates the need for pre‐
purificationofeluate.
Conclusion: Produced under GMP conditions and in
combination with the evaluated Modular‐Lab Pharm
Tracersynthesisdevicethiscombinationprovidesthe
opportunityforafullfunctionalGMPproduction.
P‐1‐30
Initial experience of Ga‐68 DOTANOC
imaginginNETinatertiarycaremedical
center
AryaA
SanjayGandhiPostGraduateInstituteofMedicalSciences
Background: Role of molecular imaging by PET‐CT
usingGa‐68DOTANOCinneuroendocrinetumors.The
objective was to analyze retrospectively the utility of
Ga‐68 DOTANOC in PET‐CT imaging in the
managementofneuroendocrinetumors.
MaterialsandMethods:PET‐CTstudywasdonein21
patients of neuroendocrine tumors [NET’s], which
included14males&10females,aged7to62yrs.They
underwent PET‐ CT study after IV injection of 74‐148
MBq of Ga‐ 68 DOTANOC. Pt. was given oral contrast
.Images were acquired 1 hr. later on PET‐CT scanner
[Biograph64slicescanner,Siemens,Germany].
Results: The NET’s included 4 cases of phaeochromo‐
cytoma,4casesofMTC,4casesofcarcinoid,1caseof
MEN‐1, 3 cases of paraganglioma, 1 case of
neuroblastoma, 4 cases of gastroenteropancreatic
NET’s which included duodenal, retroperitoneal,
esophageal&pancreatictumors.
Each case was analysed with respect to the clinical
contextwhichrevealedGa‐68DOTANOCavidin3cases
ofpheochromocytoma,1caseofneuroblastoma,3cases
of medullary carcinoma of thyroid, 1 case of MEN I, 3
cases of carcinoid, 3 cases of gastroenteropancreatic
tumors i.e. duodenal, pancreas, esophagus, 2 cases of
paraganglioma. There was no radiopharmaceutical
concentrationin1caseofpheochromocytoma,onecase
of medullary carcinoma of thyroid and one case of
carcinoidandonecaseofparaganglioma.Theinteresting
aspectsofthismolecularimagingwillbedemonstrated
informofclinicalcase.
Conclusion:ThisearlyexperienceofPET‐CTusingGa‐
68 DOTANOC in diverse patients of neuroendocrine
tumors provide further insight into Ga‐68 labeled
positron imaging and for radionuclide therapy in
metastaticneuroendocrinetumors.
P‐1‐31
Developmentandevaluationofsoftware
for Hepatopulmonary Shunt estimation
for Transarterial Radioembolization
therapyplanning
Ashish Kumar Jha, Arun C. Gandhi, Sneha Shah,
Archi Agrawal, Nilendu C. Purandare, V.
Rangarajan
TataMemorialHospital,Parel,Mumbai,India
Background:
Transarterial
radioembolisation
(TARE) is an established treatment for inoperable
hepatocellular carcinoma and liver metastases.
Radiationinducedtoxicitytothelungparenchymais
the dose limiting factor in TARE. Pre treatment
Hepatopulmonary Shunt (HPS) is estimated by
gammacameramethod.
Materials and Methods: We have developed HPS
software on XELERIS‐1.123 workstation, GE medical
systems, Milwaukee, USA for accurate calculation of
HPS.
HPS is estimated by this software post transarterial
administrationof5mCi99mTc‐MAA.Twosetsofstatic
images‐onewithaCo‐57floodphantom‐SET1and
another without the phantom ‐SET 2 were acquired
on gamma camera in anterior and posterior
projectionin256x256matrixincludinglungandliver
inthesamefieldofviewinidenticalposition.
Results: Accurate HPS calculation is mandatory, as
theradiationdoseof>30Gytothelungsmaycause
irreversible damage and is the limiting factor for
TARE.DrawingliverandlungROIisdifficultwithout
anatomical demarcations and may cause erroneous
S37
HPS calculations. A precisely drawn ROI and proper
background correction technique is mandatory to
calculateaccurateHPS.InourHPSSoftwaretheCo‐57
flood phantom image is used for accurate organ
delineation and also helps to draw precise ROI
around lung, liver and background. Pixel normalized
background correction and geometric mean
techniques are used to obtain accurate counts from
theROIforprecisecalculationofHPS.
Conclusion: The HPS software incorporates
anatomical information for ROI generation and pixel
normalization technique to calculate precise HPS
value.HPSSoftwareisalsouserfriendly.
P‐1‐32
ComparisonofTc‐99msulfurcolloidand
Tc‐99m phytate efficacy on sentinel
lymph node (SLN) identification in
patientswithearlybreastcancer
Kuan‐Yin Ko1, Ruoh‐Fang Yen1, Chiun‐Sheng
Huang2
Departments of 1Nuclear Medicine and 2Surgery, National
TaiwanUniversityHospital,Taipei,Taiwan
Background:SLNbiopsyisnowthestandardofcare
for early breast cancer. However, what the ideal
radiopharmaceutical is remain an question. The
objectiveistocompareeffectivenessoffiltered 99mTc
sulfur colloid and 99mTc phytate on SLN procedure
and prognosis in a closely followed‐up early breast
cancerpatients.
Materials and Methods: We studied 554 female
patients with T1 or T2 breast cancer but without
neoadjuvent chemotherapy and palpable axillary
lymph node. The first 292 patients underwent SLNB
using sulfur colloid and the next 262 using phytate.
Radiotracers were administered by periareolar
intradermal injection using 2‐day or 1‐day protocol.
Allpatientsunderwentlymphoscintigraphy(LSG)and
SLN identification was performed by hand‐held
gammaprobeduringsurgery.
Results: The number of SLNs identified by LSG and
gamma probe was 1.6±0.9, 4.2±3.0 in colloid group
and 1.3±0.6, 3.1±2.0 in phytate group, respectively
(P<.05).MetastaticSLNwasfound71of292patients
in colloid group and 48 of 262 in phytate group.
Medianfollow‐upincolloidandphytategroupwas60
and 55 months. Axillary recurrence was seen in 5
colloid patients, and 2 phytate patients; distant
metastasisin8colloidpatientsand5phytatepatients
(allP=n.s.).
Conclusion: Mean SLN number detected by
intraoperativegammaprobewassignificantlyhigher
incolloidgroup.Wedidn'tfindsignificantdifference
in loco‐regional/axillary recurrence, distant
metastasis and mortality between two groups. The
results of our study suggest these two
radiopharmaceuticals have different performance on
S38
thenumberofSLNsdetectionbutwithoutsignificant
influenceonpositiveSLNfrequency.
P‐1‐33
Withdrawn
P‐1‐34
Evaluation of Thyroid Stimulating
Hormone (TSH) Suppression (Lagging
Behind)StateafterRadioiodineTherapy
inHyperthyroidPatients
Mohshi Um Mokaddema, Fatima Begum, Sadia
Sultana,SimoonSalekin,NurunNahar
National Institute of Nuclear Medicine and Allied Sciences,
Dhaka,Bangladesh
Background: A few numbers of hyperthyroid
patients may show delayed recovery of thyroid
stimulatinghormone(TSH)levelinclinicallyevident
euthyroid condition after radioiodine (¹³¹I) therapy.
Thepurposeofthestudywastoevaluatetheduration
of lag in TSH recovery after ¹³¹I therapy and stable
thyroid function status in hyperthyroid patients in a
tertiaryhospital.
Materials and Method: Total 145 hyperthyroid
patients treated with ¹³¹I therapy were included.
These patients were followed up clinically and
biochemically at three months interval. Patients
having suppressed TSH with normal FT3 level and
clinically euthyroid condition were followed up
withoutgivingantithyroiddrug.
Results: At three months follow up, 25/130 (19%)
hadsuppressedTSHwithnormalFT3level.Duration
of lagging behind state of TSH was three months for
19(76%)patients,sixmonthsforfourpatients(16%)
and one year in two patients (8%). Among these
patients, 18 (72%) became hypothyroid, five (20%)
became euthyroid and two (8%) became
hyperthyroid during subsequent follow up to 15
months.15/145patientswerelostfromfollowup.
Conclusion: Lagging state of TSH may be
unexpectedly prolonged in some hyperthyroid
patients treated with ¹³¹I. These patients should be
followed up with both TSH and thyroid hormone
levels.Mostofthemdonotrequirefurthertherapy.
P‐2‐1
AssessmentofAgreementbetweenGated
SPECTMyocardialPerfusionImagingand
Gated SPECT Blood Pool Imaging for
measurementofLeftVentricularEjection
FractioninCoronaryArteryDisease
AzmalKabirSARKER,RaihanHUSSAIN,Khokon
NATH, Shamim MOMTAZ, Faria NASREEN and
LutfunNISA
National Institute of Nuclear Medicine and Allied Sciences,
Bangladesh
Background:Leftventricularejectionfraction(LVEF)
isanimportantdiagnosticandprognosticparameter
in coronary artery disease (CAD). Gated SPECT
myocardialperfusionimaging(GSMPI)isapopularly
used for non invasive quantitative assessment of
LVEF.GatedSPECTbloodpoolimaging(GSBPI)being
a radionuclide ventriculography technique is gold
standardaswellastechnicallycomparabletoGSMPI.
Good correlation of these two methods for
measurement of LVEF is reported by using
correlation coefficients. Bland and Altman show the
inappropriateness of correlation coefficient for
comparison analysis of measurement methods. The
objective was to assess agreement between GSMPI
andGSBPIformeasurementofLVEFinCAD.
Materials and Methods: Study was done in 27
patients(24men/3women)withCAD.Themeanage
was54.2±6.2yearsrangingfrom32to68years.All
patients underwent GSMPI and GSBPI with a gap of
three to sevendays. LVEF measured in rest phase of
one day stress‐rest GSMPI was compared with LVEF
measured by GSBPI performed at rest. Agreement
analysiswasdoneusingBlandAltmanplot.
Results: Differences between GSMPI and GSBPI for
measurement of LVEF at rest in same patient fell
withintwostandarddeviationofthemeandifference.
Thus the apparent overall slight underestimation of
LVEF by GSBPI (54.8±25.3) in comparison to GSMPI
(56.9±25)wasstatisticallyinsignificant.
Conclusion: There was significant overall agreement
betweenGSMPIandGSBPIformeasurementofLVEF
inCAD.
P‐2‐2
PredictionofresponsetoCRTinpatients
with
non‐ischemic
dilated
cardiomyopathy using gated myocardial
perfusionSPECT(GMPS).
Chetan.DPatel,AnirbanMukherjee,NitishNaik,
GautamSharma,AmbujRoy
AllIndiaInstituteofMedicalSciences,India
Background: GMPS plays significant role in
assessment of cardiac mechanical dyssynchrony
(CMD) which may predict the response to Cardiac
Resynchronisation therapy (CRT). The objective was
to predict response to CRT in non‐ischemic DCM
patientsusingGMPS.
MaterialsandMethods:GMPSandclinicalevaluation
was performed in 22 patients (15 male, 60.18± 9.4
year),beforeand3monthsafterCRTimplantation.In
MPS,PhaseSD(PSD)andPhasehistogrambandwidth
(PHB) were used to quantify CMD. LVEF was also
evaluated.
Results: At baseline, mean NYHA class 3.5±0.5 and
mean LVEF 27.1±6.9 %, PSD 49.7±14.7˚, PHB
151.7±57˚. At 3 month follow‐up 17 patients
respondedtoCRTwithimprovementinNYHAclass≥
1 or EF > 5%. Responders had significantly higher
PSD (53.4±13.2 vs 36.9± 13.3, p<0.05) & PHB
(165.8±54.3 vs 103.6±39.0, p<0.05) than
nonresponders. ROC curve analysis showed 70.6%
sensitivity and 80% specificity at cutoff value of 43˚
for PSD and 126˚ for PHB for prediction of response
toCRT.
Conclusion: Baseline PSD & PHB assessed by GMPS
canpredicttheresponsetoCRT.
P‐2‐3
Future Cardiac Events in Normally
Diagnosed Gated Myocardial Perfusion
SPECT(GSPECT)
Hamid Amer, K.Niaz, A.Jelani, M.Alqaseer,
M.Saleem
King Abdulaziz Hospital, National Guard Health Affairs
(NGHA),AlAhsa,KingdomofSaudiArabia (K.S.A.)
Background: Coronary heart disease (CHD) is a
major cause of mortality and morbidity and its
managementconsumesalargeproportionofnational
healthcare budgets. A normal myocardial perfusion
scintigraphy (MPS) study is associated with a very
lowrateoffuturecardiacevents.Theobjectivewasto
determine the risk of future cardiac events after a
normal myocardial perfusion scan (MPS), and
whether clinical risk factors alter the risk of future
cardiac events after normal MPS in our local
population.
Materials and Methods: The data were collected
fromthenuclearmedicinedatabaseidentifyingallthe
reportednormalmyocardialperfusionscansbetween
January 2008 and December 2011. There were 290
patientsidentifiedwithnormalcardiacnuclearscans
inthepre‐specifiedtimeframe.103ofthesepatients
weremaleaccountingfor35%ofthetotalpopulation.
Averageageatthetimeofexaminationwas60.6±11.8
yearsandthehighestagegroupwerebetween66and
70years.
Results: There were 2 patients that were admitted
with NSTEMI and went on to have diagnostic
angiograms. One of those two patients underwent
S39
percutaneous coronary intervention with stenting.
The other patient had non‐obstructive CAD and was
advisedformedicalmanagementonly.Thesefindings
areconsistentwitha0.7%riskofcardiaceventsafter
anegativescan
Conclusion:Theabovefindingsdemonstratethatthe
risk of major cardiac events after a negative nuclear
cardiac scan is low irrespective of the clinical risk
factors and is in keeping with the international
statisticsavailable.
P‐2‐4
In the Detection of Coronary Artery
disease – A Head to Head Comparison
RegardingtheDiagnosticAccuracyofthe
DobutaminestressMyocardialPerfusion
Imaging and Dobutamine Stress
Echocardiography
Sultana N1,*, Ibrahim Md2, Nisa L, CA Meshkat2,
BanerjeeS2
1Scintigraphy division, 2 Cardiology departments, National
InstituteofNuclearMedicineandAlliedSciences(NINMAS),
Dhaka,Bangladesh
Background: For the evaluation of coronary artery
disease simultaneous Dobutamine stress myocardial
perfusion imaging and dobutamine stress
echocardiography (DSE) assessed for a head to head
comparison regarding the diagnostic accuracy of the
two tests. The objective was to investigate the
sensitivity,specificity,diagnosticaccuracyofDSEand
dobutamine stress SPECT‐MPI with Tc‐99m
tetrofosmin in the detection of coronary artery
disease(CAD).
Materials and Methods: A total 80 patients with
mean age 55.0±1.02 years were included in this
study. All patients underwent simultaneous DSE
followedbyDobutaminestressmyocardialperfusion
imaginginasingledaystress–restprotocolwithTc‐
99m Tetrofosmin. Coronary angiogram was
performedwithinonemonthoftheperfusionscan.
Results:Theoverallsensitivity,specificity,diagnostic
accuracy of dobutamine stress perfusion imaging for
the detection of CAD were 96.9%, 62.5% and 90%
respectively. Positive predictive value was 91% and
negativepredictivevaluewas83.3%fordobutamine
stressmyocardialperfusion.ForthedetectionofCAD
the sensitivity of MPI and DSE were 96.9 and 92.2%
(p>0.05), while the specificity was 62.5 and 75%
respectively (p>0.05). The negative predictive value
of MPI was somewhat higher (83.3%) than that of
DSE (70.6%), although the difference between the
twodidnotreachthelevelofsignificance(p=0.064).
The predictive accuracies of MPI (90%) and DSE
(88.7%)werealsofairlycomparable(p>0.05).
Conclusion: Compare to DSE dobutamine stress
myocardialperfusiondemonstratedhighersensitivity
butwaslowinspecificity.
S40
P‐2‐5
Effect of Exercise‐Induced Maximum
Heart Rate on Liver Activity in
Technetium‐99m Sestamibi Myocardial
PerfusionScintigraphy
OliverR.Lubiano,RMT
UniversityofSantoTomasHospital,Manila,Phillipines
Background: Superimposed visceral activity is a
potential cause of artifacts in Tc‐99m Sestamibi
cardiac scintigraphy. The objective was to compare
liveractivitybetweenpatientsachieving85‐100%of
predicted maximum heart rate (PMHR) during
treadmill stress test and those who achieved >100%
ofPMHR.
Materials and Methods: A retrospective study (Jan
2010 to Dec 2013) was conducted at USTH,
comparing 53 patients who achieved 85‐100% of
PMHR on exercise (Group I) with 16 who exceeded
100% (Group II). Liver‐to‐heart uptake ratios were
computed. Statistical significance was assessed by t‐
test.
Result: The mean planar liver‐to‐heart ratio for
GroupIwas0.79±0.18whilethemeanratioforGroup
IIwas0.69±0.14(P=0.041).
Conclusion: Patients who achieve >100% of PMHR
havesignificantlylowerliveractivity.
P‐2‐6
TheimpactofAttenuationCorrectionon
Myocardial Blood Flow Quantitation
(MBFQ) with 99mTc‐sestamibi Dynamic
SPECT (dSPECT) for Detection of
CoronaryArteryDisease
Song‐HanYang
Chang Bing Show Chwan Memorial Hospital, Changhua,
Taiwan
Background:No‐ACdSPECTcanberelativelysimple
in clinical setting, but its adequateness for MBFQ is
stillunclear.
Materials and Methods: Twenty‐five patients who
received both dSPECT and coronary angiography
were included (CAD=14). Vvalues and heterogeneity
(SD/mean*100%) of flow and coronary flow reserve
(CFR) obtained from no‐AC and AC images were
analyzedandcompared.
Results: MBFQ with no‐AC dSPECT had significantly
higher values of stress K1 (21%), stress flow (49%),
CFR(243%)with2.0times(1.6‐2.4)heterogeneityof
rest/stress flow and CFR than AC dSPECT. For
detecting CAD, the areas under ROC curve of no‐AC
dSPECT was significantly smaller than that of AC
dSPECT.
Conclusion: Attenuation artifact in dSPECT can
overestimate flow values and amplify flow
heterogeneityinmyocardium.Attenuationcorrection
ismandatorytoensurethediagnosticperformanceof
MBFQwithdSPECTforCADdetection.
P‐2‐7
Incremental value of myocardial blood
flowquantitationwithTc‐99mSestamibi
dynamic SPECT/CT in the diagnosis of
coronaryarterydisease
TienTienJhang
ShowChwanMemorialHospital,Changhua,Taiwan
Background: This study evaluated the diagnostic
performance of myocardial blood flow (MBF) and
flow reserve (MFR) obtained by a dual‐head
SPECT/CTindetectingcoronaryarterydisease(CAD)
comparedwithtraditionalperfusionimages.
Materials and Methods: This study included 21
patients who had received dynamic SPECT/CT and
invasive coronary angiography. Stress MBF (SMBF),
rest MBF (RMBF) and MFR were quantified by one‐
tissuecompartmentflowmodel.Summedstressscore
(SSS) and summed difference score (SDS) were also
generated.
Results: Using ≥50% stenosis as positive CAD, areas
underROCcurve(AUCs)ofMFR,SMBF,SSSandSDS
were0.91±0.07,0.86±0.09,0.64±0.12and0.59±0.13,
for patient‐based analysis. For vessel‐based analysis,
AUCs of MFR, SMBF, SSS and SDS were 0.81±0.05,
0.76±0.06,0.62±0.07and0.56±0.08,respectively.
Conclusions:Myocardialbloodflowquantitationwith
a conventional SPECT/CT system is clinically simple
andeffectivetoenhanceCADdetection.
P‐2‐8
Does the Thallium defect pattern in
Myocardial Perfusion Scintigraphy
depict the level of stenoses in SVD
involvingtheLAD?
VishalAgarwal
Background: Apart from being invasive, coronary
angiography does not show the real effect of the
stenosesonthemyocardialbloodflow.However,the
myocardial perfusion scintigraphy shows the real
ischemic burden on the myocardium. To correlate
this reversible defect pattern and deduce some
relationship with the level of stenoses at least in
singlevesseldiseasepatients.
MaterialsandMethods:Wecarriedoutthisstudyin
326patientsoutof1200patients,inthestudyperiod
of7months,whohadSVDinvolvingtheleftanterior
descending artery. Of these, 154 patients had
proximal stenoses (proximal to and including first
major septal branch ‐ as per SYNTAX scoring for
coronary stenoses), 68 patients had mid stenoses
(afterS1originto½ofdistanceuptoapex)and104
had distal stenoses (terminal portion of LAD). The
MPI was done with dual isotope protocol in our
department.
Results:Fivepatternsofreversibleperfusiondefects
were identified: type I (apex, anterior wall and
septum),typeII(apexandseptum),typeIII(antero‐
septalwall),typeIV(apexandanteriorwall)andtype
V(apex).
Conclusions: On correlating with the CAG findings
available, proximal stenoses was most commonly
related to type I, II and III (in 138 of 154), mid
stenoses with type IV (in 54 of 68) whereas distal
stenoseswasrelatedwithtypeV(in90of104).
P‐2‐9
99mTc‐methionine(MET)BrainSPECTfor
the detection of recurrent/remnant
gliomas‐ Comparison with ceMRI and
18F‐FLT–PETimaging:InitialResults
Singh, Baljinder 1; Kumar, Narendra, Sharma,
Sarika1; Watts, Ankit1; Hazari, Puja P.2; Abrar,
ML; Singh, Harpreet1; Chuttani, Krishna2; Ghai,
Anchal; Sharma, Rajnish2; Mittal, Bhagwant R.2;
Mishra,AnilK.2
Nuclear Medicine & PET Centre, PGIMER, Chandigarh,
Chandigarh,India
2Division of Radiopharmacy and PET/Cyclotron Centre,
INMAS,DRDO,Delhi,India
3RadiationOncology,PGIMER,Chandigarh,India
1
Background: To evaluate the diagnostic utility of an
indigenouslydevelopedsinglevialreadytolabel(with
99mTc)kitpreparationofDTPA‐bis‐methionine(99mTc‐
MET‐SPECT)forthedetectionofgliomas.Theobjective
wastocomparethe 99mTc‐MET‐SPECTimagingresults
with 18F‐FLT‐PET and ceMRI data in patients with
recurrent/residualgliomas.
Materials and Methods: The conjugate (DTPA‐bis‐
MET)wassynthesizedandformulated(in‐house)into
lyophilized single vial ready to label (with 99mTc) kit
preparations and were used in the present study.
Thirty‐two (22M: 10F, mean age=43.0±16.0 yrs;
range=8‐72 yrs.) post operative gliomas cases (21‐
Glioblastoma Multiforme‐G‐IV; 04 Astrocytoma/
Oligodendroglioma‐G‐I/G‐II);
04‐
Anaplastic
Oligodendroglioma/Oligoastrocytoma‐G‐III;
03‐
Pilocytic astrocytoma –GI) were recruited in the
present prospective study. All the study subjects
underwent brain 99mTc‐MET‐SPECT and ceMRI. Brain
99mTc‐MET‐SPECT
was acquired at 2h after
administration of 555‐740 MBq activity of the
radiotracer. Additionally, sixteen (16/32) patients
underwent 18F‐FLT‐PET (mean administered activity
S41
=239.0±15.5MBq;meanuptaketime=56.0min)and2
patients underwent 11C‐MET‐PET (555.0 MBq, uptake
time20‐min)imaginginadditionto 99mTc‐MET‐SPECT
andceMRI.
Results: Concordant 99mTc‐MET‐SPECT and ceMRI
findings were observed in 28 scans (15‐positive & 13
negative). Discordant findings were observed in the
remaining5scanswithpositiveMRI&negativeSPECT
in 2‐scans and negative MRI & positive SPECT in 3‐
scans respectively. All the three investigations i.e. 18F‐
FLT‐PET, 99mTc‐MET‐SPECT and ceMRI were positive
in 9/16 and negative in 5/16 patients respectively. In
the remaining 2‐patients both 18F‐FLT‐PET and
99mTcMET‐SPECTwerepositivebutMRIwasnegative.
11C‐MET‐PETwaspositiveandnegativeinonepatient
each and the findings were in consonance with the
99mTc‐MET‐SPECT and ceMRI findings. There was no
discordance in the findings on 99mTc‐MET‐SPECT, 18F‐
FLT‐PET and 11C‐MET‐PET. The overall sensitivity,
specificity, PPV, NPV and DA of 99mTc‐MET‐SPECT
techniquewasestimatedtobe88.24%,81.25%,83.3%,
86.7%&84.8%.
Conclusion: 99mTc‐MET preferentially localized in the
sites of recurrent/residual gliomas and the technique
showed very good agreement with ceMRI and 18F‐
FLT‐PET findings. 99mTc‐Methionine SPECT imaging
thus could be a cost‐effective substitute both for 18F‐
FLTand11C‐MET‐PETimaging.
P‐2‐10
Studying the Cerebral blood flow (CBF)
in the inter‐ictal period in patients
sufferingfrommigraine.
SrivastavaMK1,KiranGP2,WadhwaJ2,PanditN1
Department of Nuclear Medicine & 2Internal Medicine,
JIPMER,Puducherry
1
Background:Migraineisacommondisablingprimary
headache disorder. Modern imaging defies vascular
theorybyshowingthatvascularanddiameterchanges
are not linked with pain. Migraine is associated with
disturbances of neuronal function and reduced
cerebral perfusion. We aimed to study the CBF in the
interictal period in migrainers using technetium‐99m
ethylcysteinatedimer(Tc‐99m‐ECD).
Material and Methods: 43 Migraine patients with
mean age of 27 ± 7.5 years were studied. A detailed
history was taken with Migraine Disability
Assessment (MIDAS) grade and score and Visual
analogscore(VAS).ThepatientsunderwentTc‐99m‐
ECD brain study within one week of diagnosis. The
images were interpreted for areas of reduced
perfusionandscoredaccordingly.
Results: The most consistent hypoperfused region
was thalamus (81.4%) with nine patients showing
bilateral thalamic hypoperfusion, followed by
temporal cortex (51.2%), basal ganglion (34.9%)
(lentiform nucleus ‐ 32.6%& Caudate lobe – 25.6%).
S42
The other hypoperfused regions were basi‐frontal
cortex in 2 patients and parietal cortex in 1 patient.
Therewasnosignificantcorrelationbetweennumber
ofhypoperfusedregionsandMIDASgrade(r=0.13)
or MIDAS score (r = 0.01) or VAS (r = ‐0.08).
However,thenumberofareahypoperfusedincreased
withdurationofdisease(r=0.55).
Conclusion: Thalamus, temporal lobe and basal
ganglionweremostconsistenthypoperfusedregions
in migraine patients. The hypoperfused area
increasedwithdurationofdisease.
P‐2‐11
Brainatlas‐basedmeancorticalSUVRfor
evaluation of positive/negative scan of
PiBPET
Takashi Kato, Ken Fujiwara, Kaori Iwata,
Yoshitaka Inui, Kengo Ito, Akinori Nakamura,
andMULNIADStudyGroup
NationalCenterforGeriatricsandGerontology
Background: The purpose of this study was to
evaluate mean cortical standard uptake value ratio
(mcSUVR) on the automated regions of interest for
thepositive/negativescanofPiBPET.
Materials and Methods: The subjects were 62
cognitivelynormalsubjects(69.8±5.3yo),25patients
with mild cognitive impairment (74.5±6.6 y.o.), and
16 patients with Alzheimer’s disease (74.9±6.1 y.o.).
The mcSUVR was calculated from spatially
normalized PET of 50‐70 min after injection of PiB
using the Automated Anatomical Labeling Atlas. The
PiB PET scans were visually rated as PiB‐positive or
PiB‐negative. Diagnostic performance of mcSUVR for
positive/negative scan was evaluated using a ROC
analysisinallthesubjects.
Result: When cut off of the mcSUVR was 1.26,
diagnostic sensitivity, specificity, and accuracy were
0.974,0.969,and0.971,respectively.
Conclusion: The brain atlas‐based mcSUVR was
usefultodiscriminatebetweenpositiveandnegative
scanofPiBPET.
P‐2‐12
Impactofright‐ventricularapicalpacing
on the optimal left‐ventricular lead
positionsmeasuredbyphaseanalysisof
SPECTmyocardialperfusionimaging
JiChen
EmoryUniversitySchoolofMedicine,Atlanta,GA,USA
Background: The use of SPECT phase analysis to
optimize LV lead positions for cardiac
resynchronization therapy (CRT) was performed at
baseline, but CRT works as simultaneous right
ventricular(RV)andLVpacing.Theaimofthisstudy
was to assess the impact of RV apical pacing on
optimal LV lead positions measured by SPECT phase
analysis.
MaterilasandMethods:Forty‐sixpatientsreceived2
SPECT scans after single injection of Tc‐99m
sestamibi under sinus rhythm and RV apical pacing.
LV dyssynchrony parameters and optimal LV lead
positions were measured by the phase analysis
techniqueandthencomparedbetweenthetwoscans.
Results: The LV dyssynchrony parameters were
significantly larger with RV apical pacing than with
sinusrhythm(P~0.01).In39ofthe46patients,the
optimalLVleadpositionswerethesamebetweenRV
apicalpacingandsinusrhythm(kappa=0.861).In6
of the remaining 7 patients, the optimal LV lead
positionswerealongthesameradialdirection,butRV
apical pacing shifted the optimal LV lead positions
towardthebase.
Conclusion:TheoptimalLVleadpositionsmeasured
by SPECT phase analysis were consistent, no matter
whethertheSPECTimageswereacquiredundersinus
rhythm or RV apical pacing. This study supports the
use of baseline SPECT myocardial perfusion imaging
to optimize LV lead positions for increasing CRT
efficacy.
P‐2‐13
Performance
Characteristics
and
Evaluation of Recently Installed PET/CT
ScanneratINMOL
AfshanAshfaq,AhmadQureshy,AreeshaZaman,
Munir Ahmed, Nouroze Gul Abubaker Shahid
andMaqsoodAhmad
InstituteofNuclearMedicine&Oncology(INMOL),Pakistan
Background: Evaluation of performance is essential
priortohumanstudies.Theobjectivewastoevaluate
the physical performance of the new integrated
PET/CT system according to NEMA and IAEA
standards.
Materials and Methods: A series of Quality control
procedures was performed on GE DiscoveryTM STE16
WholeBodyPET‐CTsystem.
Results:(1).2coldand4hotsphereswerevisiblein
3D mode with contrast values of 28.5%, 35.7%,
50.8%,69.2%fromsmallesttolargesthotspherefor
cold spheres from 53.4% and 61.6%. In 2D mode 2
coldand3hotsphereswerevisible.
(2). The average transverse and axial spatial
resolution(FWHM)at1cmoffcenterwas5.03(5.05)
mm and 10 cm off axis was 5.2 (6.1) mm in 2D, and
5.4(6.9)mmand6.1(6.6)mmin3D.
(3). The average sensitivity for two radial positions
(r=0cmandr=10cm)was1.7cps/kBqin2Dand8.4
cps/kBqin3D.
CT:
(1). All slice thicknesses (5, 3.75, 2.5, 1.25) mm are
acceptableexcept0.625mm.
(2).Standarddeviationintheimagenoiseuniformity,
for center and 2 radial positions, was 3.27, 3.2 and
3.21respectively.
Conclusion: The system has excellent overall
performance in 2D and 3D modes in particular high
sensitivity. Hence, CT alone is good enough for
diagnosticuse.
P‐2‐14
Striatal Tc‐99m Uptake Measurements
UsingVisualandP‐ModeAnalyses
Chia‐ChiChang,Wen‐ShengHuang
ChanghuaChristianHospital
Background: 99mTc‐TRODAT‐1 SPECT has been
clinically used to measure acticity of striatal (ST)
dopamine transporter. Problems remain in its semi‐
quantitation. The objective was to compare
differences between preset‐ROI and co‐registered
PMODanalysesusingaphantommethod.
Materials and Methods: A dual‐headed camera was
used for phantom imaging. 99mTc radioactivity was
adjusted to simulate clinical settings with ST/
background ratios ranged from 3:1 to 9:1, yielding
specificuptakeratios(SURs)rangedfrom1to6.The
actual radioactivity was measured by a gamma
counter.
Results: Good correlations were found between the
gammacounterandthegammacamera(r2=0.96for
preset‐ROI). Good parallelism was also noted
between preset‐ROI and PMOD methods (r2= 0.96).
The SUR reproducibility in ST and its sub‐regions
ranged0‐9.4%(averaged<5%).
Conclusion: Using visual inspection and preset‐ROI
methodtoevaluateactivityofSTanditssub‐regions
mightbeaclinicallyreliablemeans.
P‐2‐15
Self Shielded Medical Cyclotron‐ Initial
experienceindevelopingcountry
DhananjayKSingh
DR.RMLIMS
Background: At present 18 cyclotrons are in
operation and few are in process and will get
commissioned in next 1‐2 year time in India. In a
Medical Cyclotron, radiation safety aspects are more
stringent due to neutron, high energy gamma
radiation and because of this the occupational
workers of facility are very sceptical about radiation
exposure.Theobjectivewastoaccesstheproduction
capabilityofcyclotronunderdifferentcircumstances,
S43
radiationsafetyoffacilityandoccupationalworkers.
MaterialsandMethods:OurMedicalCyclotron(RDS
Eclipse‐RD,SiemensMedicalSolutionhaving11MeV
fixed energy) are capable to produce F‐18, F18‐F2
gas,N‐13,C11andO‐15radioisotopes.Theradiation
monitoringoffacilityweredoingroutinelyandevery
time before beam initialization, during production
and post production around the self shield and
outside of secondary wall of cyclotron room and
radiochemistryroom.
Results:Themeandurationofbombardmentinthere
runontheF‐18targetwas40±10.57Min,whileforN‐
13targetwas15±5.21minandforF‐18‐F2gastarget
was 90±20.53 min. Radiation levels in the cyclotron
vault are varies from 0.03 to 65 (µSv/hr) micro
Sievertperhour.Theneutrondoseratewasnotinthe
detectablerangejustbeforeandaftertheproduction
runinthecyclotronvault.
Conclusion:Theradiation(gammaandneutron)levels
werewellwiththepermissiblelimitexceptduringthe
leakageofF‐18F‐2gastargetorC‐11gastarget.
P‐2‐16
The application of different scatter
correction function settings in Siemens
SPECT
YuankaiWang,ZhuangLiu,YuSun
HuashanHospital,FudanUniversity
Background: Tomography can be corrected by
scatter correction (SC) to improve image quality.
Siemens SPECT has several function of optional
marked SC in the tomographic image reconstruction.
The aim of this research is to distinguish the
differencebetweenthedifferentfunctionsettings.
Materials and Methods: "SC‐Tc‐99m‐NMG" energy
peak of Brain model tomographic data were used.
Dual lsotopes loaded in "Tomo Reconstruction"
activity primary and secondary energy peak to
analyzeseparatelyin2groups.Singlelsotopesloaded
in"TomoReconstruction"activitydividedintoSCand
NSC to analyze separately in 2 groups. Dual lsotopes
loaded in "AutoRecon" activity divided into SC and
NSC to analyze separately in 2 groups. Limited by
"AutoRecon"activity,weuseFlash3D(8,8)gaussian
8.00functiontoreconstructandanalyzetherangeof
imagetothelargestextent.
Results:Withall128layerssummedinaxialsection,
the average radioactive counts of the 6 groups
respectively were 10092.30±24.20, 4199.40±13.41,
10092.60±24.95, 10084.30±16.05, 8151.60±20.64
and10238.80±20.64,andthemaximumcountswere
10328,3621,10370,10338,8546and10445.Except
secondary energy peak data, others met the clinical
requirements through visual assessment brain
SPECT. There was no statistically significant
differencesbetweena,c,dgroupsafterpairedTtest.
Conclusions: SC could only be done with Flash 3D
S44
functionin“AutoRecon”activityusingSiemenssyngo
V60B.
P‐2‐17
Using Bone Tomo Imaging to obtain the
volume of bone mineral density values
withSPECT/CT
YuankaiWang,ZhuangLiu
HuashanHospital,FudanUniversity
Background: In order to better define the nature of
localbonelesions,weoftenperformbonetomowith
CT imaging. In previous study (Eur J Nucl Med Mol
Imaging (2013) 40 (Suppl 2):S521), we have
established low radiation dose CT scanner scheme.
Since the CT acquisition parameters are relatively
fixed, so this is a method of obtaining stable CT
values. CT values can be analyzed to seek to obtain
themethodofvolumebonemineraldensity.
Materials and Methods: We used SIEMENS Symbia
T16. Using three kinds of uniform liquid of known
density contrast agents (350mg/ml, 300mg/ml,
282mg/ml), diluted to (225 mg/ml, 200mg/ml, 191
mg/ml, 150mg/ml, 140mg/ml). All of the 8 kinds of
reagents were filled with 5ml ampoules. CT scanner
acquisition to ampoules in accordance with bone
tomoconditionandtheliquidvolumeCTvalue(HU)
is analyzed according to the previous plan after CT
imagereconstruction.
Results: The relation between the volume of bone
mineral density values(y) and CT value (x):
y=0.034x+93.84R2=0.983.SincetheupperlimitofCT
(normal) device is 3071, the liquid density higher
than225mg/mlcannotgetthecorrectCTvalues.
Conclusion: Since the SPECT / CT rack cannot be
rotated and cannot measure QCT accurately.
However,CTdatacanbeusedtoobtaintheresultsof
volumebonemineraldensityofbone,itcannotonly
to give a clinical reference, but can also be used as
meansforsemi‐quantitativeanalysis.
P‐2‐18
Optimization of FDG PET/CT scanning
forObeseoncologyPatient
Afshan Ashfaq1, Ahmad Qureshy, Numair
Younis, Areesha Zaman, Khalid Masood, Munir
Ahmed,AbubakerShahidandMaqsoodAhmad2
1 Institute of Nuclear Medicine & Oncology (INMOL),
Pakistan
2 Centre for High Energy Physics, University of the Punjab,
Pakistan
Background: Positron Emission Tomography/
ComputedTomography(PET/CT)with 18F‐FDGisan
essential modality for cancer imaging and provides
accuratelesiondetectionandimprovedimagequality
thanPETandCTalone.DuringtreatmentofOncology
patient repeated essential PET/CT scans includes,
pre‐therapy for determination of staging, post‐
therapy for monitoring of chemotherapy response
and follow up scan. These repeated PET/CT scan
increases radiation exposure especially in obese
patients. The aim of the study is to optimize the
PET/CTscanningtowardradiationdosereduction.
Material and Method: In this study, a group of 83
patientswithweightof(75‐120kg)wereacquiredon
GE Discovery STE PET/CT scanner. Acquisition
parameters kV, mA and noise index were adjusted.
From each scan volume CT dose index (CTDIvol) and
dose length product (DLP) were recorded. For
quantitative analysis of image quality, percentage
Coefficient of variance (COV) was calculated from
specificliverslice.
Results: The CTDIvol and DLP radiation doses were
reduced by 23% and 57% respectively by adjusting
CT acquisition parameters. The entire studies were
considereddiagnosticallysufficient.
Conclusion: Significant radiation dose reduction can
be obtained by the modification of acquisition
parameters for CT in preference to PET without
degradationinimagequalityforobesepatients.
P‐2‐19
Semiquantification of Captopril Renal
ScintigraphyindetectionofRenalArtery
StenosisanditsPrognosticValue
Ching‐ChuLu,Vin‐CentWu,Kwan‐DunWu,Kai‐
YuanTzen,Ruoh‐FangYen
NationalTaiwanUniversityHospital,Taipei,Taiwan
Background: Renovascular hypertension caused by
renal artery stenosis can be accurately diagnosed by
Captopril renal scintigraphy. It provides evidence of
the necessity performing renal revasculization and
subsequent
renal
function
improvement.
Traditionally changes in patterns of renographic
curvesafter Captoprilisused togiveprobabilitiesof
renal artery stenosis. Some semiquantification
parameters such as changes of 20‐min to maximum
ratio, split renal function or peak time are helpful to
increase the accuracy. In this study, five
semiquantification parameters generated from
Captopril renal scintigraphy, changes of peak time
(Δpeak),half‐timefrompeakvalue(ΔT1/2),20‐minto
maximumratio(Δ20),estimatedglomerularfiltration
rate (ΔGFR), and split renal function (Δsplit), are
evaluatedtodecidetheirabilitytodetectrenalartery
stenosisandpredictivevalueofprognosisafterrenal
artery revasculization.The objective was to identify
the ability of detecting renal artery stenosis and
predictive value of prognosis after renal artery
revasculization by semiquantification parameters
derivedfromCaptoprilrenalscintigraphy.
MaterialsandMethods:FromAugust2004toAugust
2012, 39 renal arteries in 21 patients were included
in this study. All these patients were clinically
manifested as hypertension and receiving renal
artery angiography within three months after
Captopril renal scintigraphy. Significant Renal artery
stenosiswasdefinedasgreaterthan50%stenosisin
diameter. Changes of five semiquantification
parameters before and after Captopril were
expressed in percentage. Vessel‐based analysis was
performed with dividing into two groups, significant
stenosis and non‐significant stenosis and five
semiquantification parameters were compared
between two groups. Patients receiving renal artery
revasculization were divided into two groups, with
positive outcome (normotensive blood pressure
without antihypertensive medication) and with
negative outcome (no improvement in hypertension
and/or requiring antihypertensive medication), and
five semiquantification parameters were analyzed to
decide their ability of predicting outcome after
revasculization.
Results: Among 39 renal arteries, 9 were with
significant stenosis and 30 were patent or with non‐
significant stenosis. Average changes of five
semiquantification parameters (Δpeak, ΔT1/2, Δ20,
ΔGFR and Δsplit, expressed as mean ± SD) in
significant stenosis group were 0.0426±0.6002,
0.8613±1.9208,‐0.5303±0.2883,‐0.2266±0.3597and
‐0.1149±0.1637,separately.Averagechangesinnon‐
significant stenosis group were 0.6041±0.9898,
1.8133±5.7426, 0.1831±0.3594, 0.1516±0.3668 and
0.0055±0.0781, separately. Δpeak and ΔT1/2 were
failedtodifferentiatingrenalarterystenosis(pvalue
= 0.06 and 0.32, separately), while Δ20, ΔGFR and
Δsplit can effectively detect renal artery stenosis (p
value=0.04,0.005and0.004,separately).Among30
patent or non‐significant stenotic vessels, according
to renographic curve changes, 6 were in high
probability,18wereinintermediateprobabilityand6
were in low probability. To distinguish high
probability from intermediate probability, Δpeak,
ΔT1/2andΔ20showedstatisticalsignificancewithp
value of <0.0001, 0.0479 and 0.0170, separately. For
differentiating high probability from low probability,
ΔpeakandΔ20showedstatisticalsignificancewithp
value of 0.0063 and 0.0172, separately. ΔGFR is the
only one parameter showed ability to distinguish
intermediateprobabilityfromlowprobability,withp
value of 0.0337. Furthermore, there were 6 patients
with significant renal artery stenosis receiving
revasculization.Twoofthemshowedimprovementof
hypertension, and the other four showed no
improvement of hypertension. Δsplit is the only
parameter that correctly predict clinical outcome
after revasculization, with average changes of ‐
0.3912±0.0352 in positive outcome group and ‐
0.0183±0.4182innegativeoutcomegroup(pvalue=
0.0005).
Conclusion: Captopril renal scintigraphy is a useful
tool to diagnosis renal artery stenosis. Numerous
semiquantification parameters generated from
S45
renogram with their changes before and after
captoprilwerehelpfultodecidewhetherrenalartery
is with significant stenosis or not. Δ20, ΔGFR and
Δsplit can effectively achieved this goal. With
additional
information
provided
by
semiquantificationparameters,itispossibletoshow
more evidence to determine significant renal artery
stenosis than using traditional three probabilities,
Finally, by the changes of spilt renal function,
physicians will be more confidence to perform renal
artery revasculization due to its excellent ability to
predictclinicaloutcome.
P‐2‐20
Cisplatin Induced Sever Renal Injury‐
Scintigraphic Evaluation Using Tc‐99m
DTPA
MuhammadNouman
ArmedForcesInstituteofPathology,Rawalpindi,Pakistan
Background: The purpose of this study was to
evaluate cisplatin induced severe renal injury by
using tc‐99m DTPA in patients undergoing
chemotherapy with cisplatin based regimens in a
Cross‐sectional study with a sample size of 62
patients
Materials and Methods: Patients who were
candidatesforcisplatinbasedchemotherapyregimen
with normal renal function as evidenced by normal
RFTsandanormalvalueofageadjustedGFRonTc‐
99m‐DTPA renal scintigraphy as per guidelines of
National kidney foundation were subjected to a post
chemotherapy Tc‐99m‐DTPA renal scintigraphy
within 02 weeks of completion of 06 cycles cisplatin
based chemotherapy. Post chemotherapy GFR was
calculated.
Results: Out of 62 patients, 48 were males and 14
were females. The severe renal injury was
determinedas2/62(3.2%)
Conclusion: This significantly low prevalence of
severe renal injury does not warrant any restriction
onthecommonuseofcisplatin.
P‐2‐21
Withdrawn
S46
P‐2‐22
Association of Ultrasound and DMSA
Findings among Pediatric Patients (Ages
2–12Years)withUrinaryTractInfection
(UTI) Admitted at University of Santo
TomasHospital(USTH)
NiloC.Lopez,JrM.D.
UniversityofSantoTomasHospital,Manila,Phillipines
Background: Performing both ultrasound and DMSA
renalscaninyoungchildrenwithUTI,givenourlocal
set‐up, is neither realistic nor practical. DMSA is
considered the gold standard in detecting renal
scarring.Ultrasound’snon‐invasivenatureanditslack
of ionizing radiation are advantages of this method.
However, the sensitivity of ultrasound in detecting
renalcorticalscarringisnothigh.Theobjectivewasto
determine ultrasound findings associated with renal
scarringasseeninDMSArenalscan.
Materials and Methods: We conducted a
retrospective review of records of pediatric patients
(30 boys/52 girls, mean age= 6 years old) with UTI
who were admitted to USTH. Imaging reports were
retrievedandcomparedtheultrasoundfindingswith
reportsofDMSAstudy.
Results: There is a significantly higher proportion of
children with sonographically enlarged kidney,
diagnosed with renal scarring [P<0.001]. Similarly,
there is a significantly higher severity of
hydronephrosis in children diagnosed with renal
scarring [Z=4.128, P=0.042]. There is however, no
relationship exists between renal scarring and
pelvocaliectasia(P=1.000)acrossdifferentagegroups.
Conclusion: Our results indicate that ultrasound
findings of enlarged kidneys and increasing severity
of hydronephrosis are associated with a high
incidenceofrenalscarring.
P‐2‐23
Normal Functioning Fused Pelvic
Kidneys: Case Series from Nuclear
MedicinePerspective
Parvez Ahmed, Kabiruzzaman Shah, Nasrin
Begum, Mosharruf Hossain, Tasnim Ahmed,
SharifulIslamChowdhury,RafiqulIslam
Institute of Nuclear Medicine and Allied Sciences, Rajshahi,
Bangladesh
This study describes two cases having fused
pelvic kidneys who were first detected by
ultrasonographicexamination.Onecasewas24‐year‐
old female and the other case was 21‐year‐old male.
Bothcaseswerereferredtoourinstitutefordiuretic
renal scintigraphy. Their urinary drainage system
wasassessedandtherenalscintigraphyshowedthat
theirfusedpelvickidneyswerefunctioningnormally.
The authors also present the diuresis renography
findings of these cases to depict the fusion and
position related anomalies of the kidneys which are
veryrarecongenitalsituationoftheurinarytract.
P‐2‐25
FrequencyofDelayedGastricEmptyingin
Type‐2DiabeticPatientswithSuspected
Gastroparesis
SaimaSeher
P‐2‐24
Nuclear Medical Centre, Armed Forces Institute of
Pathology,Rawalpindi,Pakistan
Radionuclide Lymphoscintigraphy in the
Evaluation
of
Lower
Extremity
Lymphedema–SingleHospitalExperience
Background: Diagnosis of gastroparesis requires
quantitation of gastric emptying time. Scintigraphy
providesacosteffectivesolution.Theobjectivewasto
determinethefrequencyofdelayedgastricemptyingin
type‐2diabeticpatientswithsuspectedgastroparesis,
throughscintigraphicevaluationofgastricretention.
Materials and Methods: This descriptive, cross‐
sectional study conducted from Jan to Apr 2014
included type ‐ 2 diabetics with suspected
gastroparesis. Percentage gastric retention was
determined at 1, 2, 3 and 4 hours after ingestion of
radiolabelled meal. Percentage gastric retention of
>10%at4hourswasconsideredabnormal.
Results: 85 patients (56 females, 29 males) were
included. Delayed gastric emptying was observed in
28/85(32.9%)patients.
Conclusion: Frequency of delayed gastric emptying
was32.9%.
PerveenR,SultanaN,JabinZ
NationalInstituteofNuclearMedicine&AlliedSciences
Background: Lymphoscintigraphy (also known as
isotope or radionuclide lymphangiography) is the
main investigation to establish the diagnosis of
lymphedema and visualize peripheral lymphatic
channel. Lymphedema (oedema that results from
chronic lymphatic insufficiency) is a chronic disease
due to accumulation of tissue fluid in the interstitial
spaces, resulting from obstruction or defective
lymphaticdrainage.Lymphoscintigraphyhasbecome
the standard investigation in the evaluation of
lymphedema and ensure the therapies that can
properly diagnosed and characterized with
Iymphoscintigraphy.Theobjectivewastoreviewour
hospitalexperienceintheuseoflymphoscitigraphyto
evaluatelymphedemaoflowerextremities.
Materials and Methods: We retrospectively
identified all the cases with lower limb lymphedema
referred for lymphoscintigraphy from January 2014
to June 2014.The scans were performed after
subcutaneous injection of 99mTc‐nanocolloid in the
firstinter‐digitalspaceinbothfeet.
Results: Total 28 patients (F= 11 and M=17 (ratio of
1:1.7; age range 10 ‐55 years)) had undergone
lymphoscitigraphy. Seven patients (25%) revealed
normalflowinbothlimbs,twenty‐onepatients(75%)
consistent with secondary lymphedema, where six
patients(21.4%)revealedbilateralpartialobstruction
and twelve patients (42.8%) had unilateral partial
obstruction and unilateral total occlusion is found
about3patients(10.7%).
Conclusion: Lymphoscintigraphy is frequently
misdiagnosed, treated too late or not treated.
Lymphatic flow and sites of lymphatic drainage can
readily be evaluated with lymphoscintigraphy, and
this imaging can play a pivotal role in defining the
etiology of lower extremity swelling and ensure the
effective therapies. It is safe and effective for the
evaluationoflymphedemainlowerextremity.
P‐2‐26
Evaluation of GFR in Indian Population:
Comparison of Serum Creatinine based
estimatingequationsandgammacamera
based GFR by Gates protocol with GFR
measured by plasma clearance of Tc‐
99mDTPA
ShefaliM.Gokhale,A.V.Mulay
InlaksandBudhraniHospital,Pune
Background: In clinical practice, GFR assessment by
plasma clearance of Tc‐99m DTPA is considered
standard. The objective was to compare GFR
estimation by gamma camera based Gates protocol
and S. Creatinine based predicting equations with
GFRmeasuredbyplasmaclearanceofTc‐99mDTPA.
MaterialsandMethods:Eightyfourpatients(50male
and 34 female) underwent Tc‐99m DTPA renal scan
followed by withdrawal of venous blood samples as
perpredefinedprotocol.GatesmethodGFR(GFRs)was
generated. GFR by plasma sampling (GFRp) was
calculated by the slope‐intercept method with
provision for corrections. Cockroft‐Gault,4 variable
MDRD and CKD‐EPI equations based on serum
creatinine were used to generate GFRCG, GFRMDRD,
GFRCKD‐EPIrespectively.
Results: GFR estimated by all three estimating
equations correlated better than GFRs with GFRp. For
S47
estimatingGFRp,GFRCKD‐EPIhadleastbiasandalsowas
themostprecise.GFRswastheleastprecisemethod.
Conclusion: Three estimating equations based on
serum creatinine are superior to Tc‐99m DTPA
scintigraphy for estimating GFR; CKD‐EPI equation
beingthemostaccurateandprecise.
P‐2‐27
Ultrasound Correlation of Renal Cortical
Thickness and Renal Scintigraphy Using
Technetium‐99m
Diethylenetriamine
Pentaacetic Acid(DTPA)In Patients with
Decreased
Renal
Function:
A
RetrospectiveStudy
TrishaNoelleDJ.Reyes
UniversityofSantoTomasHospital,Philippines
Background: Renal cortical thickness (RCT) and
decreased renal function on renal scintigraphy are
possibleindicatorsofrenaldisease.Theobjectivewas
to compare RCT measured through ultrasound with
splitrenalfunctionbasedonDTPAscan.
MaterialsandMethods:Thestudyincludedatotalof
44adults(26male,18female;meanage55.86±16.86)
with renal ultrasound and DTPA scan from 2011 to
2013.
Results: The pathologic kidney with decreased split
renal function shows a decreasing trend on the mean
RCT compared to the normal side of the kidney,
although not statistically significant. RCT may also
predictanabnormalsplitrenalfunction.
Conclusion: RCT of the pathologic kidney may be
directlyrelatedtosplitrenalfunction.
consecutivePET‐CTwhole‐bodyscansperformedona
totalof5907patientswhowerereferredforsuspected
malignancies or staging purposes retrospectively and
prospectively. In the light of regional outdoor
temperature (C°) and by taking into consideration of
age,genderandbodymassindex(BMI)eachABAT(+)
patient was enrolled one to one with three BAT(‐)
subjects.
Results: 25 out of the 5907 screened individuals
fulfilling the criteria for study ( 9 men, 16 women)
demonstrated brown fat tissue uptake [ABAT(+)
subjects]. After adjustment for potential confounders,
ABAT(+)grouphadlowertotalcholesterol,lowdensity
lipoproteincholesterol(LDL),alaninaminotranspherase
(ALT)andaspartatetransaminase(AST)levels(p<0.05).
The levels of serum triglyceride and high density
lipoprotein (HDL) were not significantly different
between ABAT(+) and BAT‐negative subjects. In
addition, the prevelance of NAFLD in cases with
ABAT(+)waslowercomparedtoBAT(‐)(P<0.01).
Conclusion: In conclusion, our study showed that the
presence of ABAT in adults has positive impact on
bloodlipidprofile,liverfunctiontestsandalsoreduces
the prevalence of NAFLD suggesting that active BAT
may be a potential target for preventing and treating
dyslipidemiaandNAFLD.
P‐2‐29
HowtoreduceradiationDoseinsentinel
scintigraphy? Comparison of two versus
four injection site technique in breast
carcinoma
Withdrawn
P‐2‐28
P‐2‐30
Association Between The Presence of
Active Brown Adipose Tissue and Blood
Lipid Profile, Liver Function Tests and
NonAlcoholicFattyLiverDiseaseinAdult
Humans
Oatmeal labeled with 99mTc‐DTPA as a
stablesemisolidalternativetestmealfor
gastricemptyingscintigraphy
S.Ozguven1, T.Ones1, Y.Yilmaz2, F.Dede1, T.Y.
Erdil1,S.Inanir1,N.Imeryuz2,H.T.Turoglu1
Marmara University Pendik Training and Research Hospital,
DepartmentofNuclearMedicine,Istanbul,Turkey
2Marmara University Pendik Training and Research Hospital,
DepartmentofGastroenterolgy,Istanbul,Turkey
1
Background: The aim of this study is to investigate
whether the presence of activated brown adipose
tissue (ABAT) in patients undergoing FDG PET‐CT
examinations for suspected malignancy or staging
purposesisrelatedtobloodlipidprofile,liverfunction
testsandnon‐alcoholicfattyliverdisease(NAFLD).
Materials and Methods: We analysed 11820
S48
Chia‐JuLiu,1Ping‐HueiTseng,2Mei‐FangCheng,1
Yih‐Hwen Huang,1 Ruoh‐Fang Yen,1 Kai‐Yuan
Tzen,1andYen‐WenWu1,23,4,5*
Departments of Nuclear Medicine and 2 Internal Medicine,
National Taiwan University Hospital, National Taiwan
UniversityCollegeofMedicine,Taipei,Taiwan
3 DepartmentofNuclearMedicineand 4 CardiologyDivision
of Cardiovascular Medical Center, Far‐Eastern Memorial
Hospital,NewTaipeiCity,Taiwan
5 National Yang‐Ming University School of Medicine, Taipei,
Taiwan
1
Background:Theuseofradiolabeledtestmealswith
scintigraphy is considered the gold standard for
measurement of gastric emptying (GE). Instant
oatmeal has been proposed as a good alternative to
the standardized low‐fat egg‐white test meal. The
objective was to evaluate the stability and labeling
efficiency of instant oatmeal using technetium‐99m
(99mTc)‐DTPA, in comparison with other commonly
testmealsusedinGEscintigraphy.
Materials and Methods: 99mTc‐DTPA (4.6 MBq) was
mixedwitheachmealincludingscrambleegg,cheese,
oatmeal and ensure, and placed in a glass tube
containingfreshhumangastricjuice.Samplesofeach
meal were separated to solid meal from the liquid
elute, and the activity before and after filtering was
assayedinadosecalibrator.Thepercentageofinitial
radioactivity remaining with the meal of admixture
wasmeasuredandcompared.
Results: Scramble eggs and cheese had least
breakdown with radioactivity of solid parts (> 98%
and 96%, respectively). The oatmeal meal also had
high binding stability more than 90%, as good as
scramble eggs and cheese (P=NS) within 2 hours.
Althoughslightlylowerstabilityafter2hours(85.7%,
85.1% and 86.3% for 2, 3 and 4 hrs respectively, all
P<0.05), it remained in semisolid appearance with
acceptable binding stability. On the other hand,
Ensure presented mainly as liquid with lowest
radioactivity(77.3%)after30minutes.
Conclusion: Oatmeal could be served as an
alternativetestmealforGEscintigraphyduetogood
stability and labeling efficiency in semisolid form in
gastricjuice.
P‐2‐31
Noninvasive rest and acetazolamide
brainperfusionone–dayprotocolusing
SPECT/CT
Dang An Binh1, Bui Dieu Hang1, Tran Song
Toan1, Tran Minh Tri1, Tran Vu Quynh Vy1,
MassanobuIshiguro2,HiroshiToyama2
Cooperateprojectbetween 1ChoRayHospital,HoChiMinh,
Viet Nam & 2Fujita Health University Hospital, Toyoake,
Japan
Background: Brain perfusion SPECT imaging has
been a useful way to evaluate cerebro‐vascular
diseasesandotherneurodiseases.Two‐dayprotocol
brain perfusion SPECT is more accurate but not
convenientformostpatients.Thisisthereasonwhya
one–dayprotocolusingSPECT/CTwasdesigned.
Materials and Methods: Both rest and acetazolamide
was done by SPECT/CT system. A 2 minute ‐ dynamic
acquisition was carried out immediately after injection
of 99mTc ‐ HMPAO. Then, the 1st rest SPECT study was
donefor30minafter3minpostinjectionof370MBq
(10 mCi) of 99mTc ‐ HMPAO. Immediately after the 1st
SPECT, 1g of acetazolamide was given intravenously.
Tenminuteslater,740MBq(20mCi)of 99mTc–HMPAO
was additionally injected. Three minutes later the 2nd
SPECT study was carried out for 30 min. To measure
regional cerebral blood flow (rCBF) non‐invasively, the
Patlakplotanalysiswasappliedtotime–activitydataon
radionuclide angiography. Then reconstructed images
from1stSPECTwereconvertedto1strCBFmap.Baseon
the increased count ratio in cerebellum between decay
corrected 1st and 2nd SPECT images, acetazolamide
increasingratiowascalculated,andthen2ndrCBFmap
was generated. Region of interest (ROI) in 1st and 2nd
imageswereset,then%increasevalueswerecalculated.
Results: Thirty‐three patients were performed. The
rest cortices showed rCBF values by 49.3 ± 3.3
ml/100gbrain/min,acetazolamideenhancedcortices
show rCBF values by 53.8 ± 4.0 ml/100g brain/min
and%increasevalueby8.9±3.7onaverage.
Conclusion: This method of imaging would be
significant for evaluating cerebral perfusion reserve
in the routine cerebro‐vascular disease for a
comfortable method to patient because they do not
havetocometohospitalin2daysforscanning.
P‐2‐32
Effect of CarekV on image quality & R.D
inPET/CTexamination
RidhimaBhayana,RaviKantGupta,VarunDhull
Background: To find the effect of CarekV on image
quality & effective radiation dose(R.D) in PET/CT
examination.
MaterialsandMethods:Thisstudyincluded37patient
who had another PET/CT scan done on the same
machine(SeimensBiographmCT,withoutCarekV)with
the same CT parameters except CarekV. R.D in CT was
calculated. Both scans of these pt were analysed for
imagequalitygradingscore(G.S)onscaleof1‐4(1‐Non
diagnostic to 4‐excellent). Images were compared for‐
noise,contrastresolution,edgedefinition,overallquality
&4organs.G.Swascalculated&compared.
Result: Using CkV, mean R.D significantly reduced
from 11.7 to 11.0 mSv ( p value‐0.002) & mean G.S
significantly increased from 20.24 to 22.36 (p value‐
0.0117).
Conclusion: Using CkV in PET/CT examination, CT
R.D to the patient can be reduced significantly
withoutcompromisingtheimagequality.
P‐2‐33
ComparisonofSPECTstudyperformances
between 6 months and 3 years after the
Fukushima Daiichi nuclear power plant
disasterquestionnairesurvey
ShigeruKosuda
NationalDefenseMedicalCollege,Japan
Background: To assess the disaster effect on SPECT
S49
study performances obtained by sending a
questionnaire sheet to the institutes in Saitama 6
months and 3 years after the Fukushima Daiichi
nuclearpowerplantdisaster.
Materials and Methods: A questionnaire sheet was
sent to the departments of NM in 33 hospitals of
Saitama Prefecture where is located 80 to 100 km
south of the Fukushima Daiichi nuclear power plant
as of September 15th, 2011 and June 15th, 2014. All
ofthehospitalsexcept3answeredthequestionnaire.
Results: 50% (15/30) of the hospitals described
continued decrease in the number of NM studies
(NMS)6monthsafterthedisaster.However,allbut3
showed return to the number of NMS before the
disaster in the survey 3 years after the disaster.
Approval rate of domestic supply of Mo‐99/Tc‐99m
generator was 54% 6 months after the disaster and
increased to 60% 3 years after that. Eight patents
(16%)expressedexposureuneasyorfearbeforeNMS
6monthsafterdisaster.Oneofthemshowedafeeling
likecancellationofNMS.However,twopatients(4%)
expressedexposureuneasiness3yearsafterthat.
Conclusion:TheFukushimaDaiichidisasterresulted
inreductionofthenumberofNMSandillaffectedthe
patients’ feeling regarding exposure. The situation
hasbeenimprovingbuttosomeextentremainstobe
solved.
P‐2‐34
A combination of different scintigraphy
techniques in hyperparathyroidism
assessment
Tran Song Toan, MD*; Dang An Binh; Tran Vu
QuynhVy;BuiDieuHang,MD
Department of Nuclear Medicine, Cho Ray Hospital, Ho Chi
Minh,VietNam
Background:Becauseofthesmallsizeandlocationof
normal parathyroid glands, diagnostic imaging with
mostmodalitiesisdifficult.Hyper‐functioningglands,
however, can be imaged by using nuclear medicine
techniques. The objective was to confirm the role of
99mTc‐sestamibi
imaging
in
diagnosis
of
hyperparathyroidism.
MaterialsandMethods:Allpatients,whohadclinical
suggestion of hyperthyroidism, underwent a neck
ultrasound(US),99mTcO4‐(sodiumpertechnetate)and
99mTc‐sestamibi planar images and SPECT/CT study.
Dual‐phase 99mTc‐sestamibi procedure was used
.Then a 20‐minute SPECT/CT study was done
immediately after finished the delayed phase.
99mTcO4‐ imaging would be done on the next day. All
processed imaged were visually compared together,
then the results of these preoperative localization
studies were compared to surgical and pathological
dataofpatients.
Results: From May 2010 to September 2013, 48
consecutive patients are enclosed in this research.
S50
Thirteen men and 35 women were studied with
median PTH value was 277 pg/mL (normal < 70).
Twentytwopatientshadthyroidnodules.Sensitivity
andspecificityofSPECT/CTobservedinourpatients
were88.8%and93.3%.
The overall correlation between the diameter of
nodules with PTH value was highly significant
(r=0.72).
Conclusion: A combination of planar imaging of
99mTc‐MIBI, 99mTcO4‐and SPECT/CT scan showed the
highest sensitivity (88.8%) and specificity (93.3%),
appeared to be a highly accurate preoperative
imagingprocedureinprimaryhyperparathyroidism.
P‐2‐35
Haemodynamically significant Coronary
Artery Disease detected by Myocardial
Perfusion Imaging can be predicted by
CarotidIntimaMediaThickness
Tapati Mandal, Lutfun Nisa, Nasreen Sultana,
FariaNasreen
Department of Nuclear Medicine, National Institute of
NuclearMedicineandAlliedSciences,Dhaka,Bangladesh
Background: Increased Carotid Intima Media
Thickness (CIMT) has been used as a surrogate
marker of atherosclerosis and can predict
cardiovascular risk. The objective was to assess the
diagnostic performance of CIMT for prediction of
haemodynamicallysignificantCADdetectedbyMPI.
Materials and Methods: We studied 40 patients (40‐
50 years of age) with cardiovascular risk factors. MPI
wasdonewithTc99mSestamibi.CIMTwasmeasured
with B mode high resolution (7 MHz) ultrasound
scanner.
Results: Summed stress score (SSS) of SPECT MPI
images were used for optimum correlation with the
CIMT. Patients with normal MPI (n‐23) had either
normal (<1 mm in 11 patients) and/ or mildly
increased(1‐<1.3mmin12patients)CIMTand16of
the 17 patients with myocardial perfusion defect
showedconsistentlyhighCIMT.Adirectrelationship
was observed between the degree of CIMT and the
extentandseverityofperfusiondefectasanalyzedby
the Pearson’s correlation coefficient (positive
correlation of r=0.055, statistically highly significant
P<0.001).TheCIMTvalueof≥1.25mmwasfoundto
beapredictorofabnormalperfusiondetectedbyMPI
(sensitivity‐70.6%,specificity‐87%,PPV‐80%and
accuracy‐80%).
Conclusion: A CIMT of ≥ 1.25 mm can significantly
predict the haemodynamic effect of atherosclerotic
lesionsonmyocardialperfusioninpatientswithrisks
ofCADwithanaccuracyofabout80%.
P‐2‐36
Degree of myocardial perfusion & fatty
acid metabolism mismatch and its
correlationwithLVremodelingfollowing
successfully reperfused ST segment
elevatedmyocardialinfarction(STEMI)
ShankarKumarBiswas1,MasayoshiSarai2,Hiroshi
Toyama2,MasatsuguIwase2,YukioOzaki2
InstituteofNuclearMedicine&AlliedSciences,Dhaka
FujitaHealthUniversity,Japan
1
2
Background: Discordant 123I‐β‐methyl‐iodophenyl
pentadecanoic acid (BMIPP) and 99mTc‐tetrofosmin
(TF) uptake is designated as viable dysfunctional
myocardium.Alittleisknownaboutit’srelationwith
leftventricular(LV)remodeling.Theobjectivewasto
unravel the impact of the degree of BMIPP‐TF
mismatch and it’s correlation with change of LV
volumefollowingsuccessfullyreperfusedSTEMI.
Materials and Methods: Twenty five patients with
STEMI underwent emergency percutaneous coronary
intervention.BMIPPandTFcardiacscintigraphywere
performedaround7daysofadmission.Adifferenceof
BMIPPandTFdefectscoreby≥4wereconsideredas
mismatched defect. Echocardiography was performed
within 24 hrs of admission and at 3 months interval.
End diastolic volume index (EDVI) and end systolic
volumeindex(ESVI)wererecordedaccordingly.
Results: Twenty one patients showed BMIPP‐TF
mismatcheddefectandrest4showedmatcheddefect.
Twelvepatients(48%)showedreductionofEDVIand
14(56%) patients showed reduction of ESVI over 3
months. Mismatched defect score showed significant
correlation with the relative change of EDVI (P=
0.002,r=0.58)andESVI(P=0.043,r=0.40).
Conclusion: The degree of dysfunctional viable
myocardium showed nice correlation with the
reduction of LV volumes following successfully
reperfusedSTEMI.
P‐2‐37
Incremental value of stress‐induced
dyssynchrony on early post‐stress Tl‐
201 gated SPECT in the diagnosis of
coronaryarterydisease
Guang‐UeiHung
ChangBingShowChwanMemorialHospital
Background: Previous studies showed different
dyssynchronypatternsbetweenischemicandnormal
myocardium at early post‐stress using Tl‐201 gated
SPECT. The aim of this study was to assess the
relation of stress‐induced dyssynchrony and the
extentofcoronaryarterydisease(CAD).
Materials and Methods: 144 patients were
retrospectively analyzed. With ≥70% stenosis as the
criteriaofCAD,57hadnoCAD,32had1‐vesseldisease,
36 had 2‐vessel disease, and 19 had 3‐vessel disease,
respectively. LV global and territorial dyssynchrony
parametersweremeasuredbythephaseanalysisfrom
stress/rest Tl‐201 SPECT and compared between
stressandrestamongthepatientgroups.
Results: The patients with multi‐vessel CAD had
significantly more global dyssynchrony than the
patients without ≥70% stenosis at stress. In the
patientswithmulti‐vesselCAD,stressimagesshowed
significantlymoreglobalandterritorialdyssynchrony
thantherestimages.Morepatientswith3‐vesselCAD
were correctly classified as multi‐vessel disease,
when combining both visual interpretation and
dyssynchronyassessment.
Conclusion: The patients with multi‐vessel CAD had
significantlymoreglobalandterritorialdyssynchrony
at early post‐stress than at rest. Such quantitative
measures of myocardial stunning may assist in the
diagnosisofmulti‐vesselCAD.
P‐2‐38
99mTc‐HMPAO
nano liposomes, an
excellent RBC substitute for blood pool
imaging
SadriK1,*,MomenypoorS2,DabbaghKakhkiVR1,
SadeghiR1,AryanaK1,JohariDahaF3,ZakaviSR1,
JaafariMR2
1 NuclearMedicineResearchCenter,MashhadUniversityof
MedicalSciences(MUMS),Mashhad,Iran
2BiotechcologyResearchCenter,NanotechnologyResearch
Center,SchoolofPharmacy,MUMS,Mashhad,Iran
3 Nuclear Science and Technology Research Institute, Tehran,
Iran
Background:InvitrolabelingofRBCwith 99mTc isan
intricateprocedureandthereisalwaysaneedforan
alternate blood pool imaging agent. The aim of this
studywastoprepareaneffectivenanosizedliposome
(NLs)similartohumanredbloodcellforbloodpool
scintigraphy.
Materials and Methods: PEG‐NLs and none PEG‐NLs
were prepared using film method plus high pressure
homogenizationtechnique.Planarimageswereacquired
using a 256 × 256 matrix 0, 1, 2 and 24 h after 99mTc‐
HMPAO‐NLsinjection.SPECTimageswereobtained15
minafterinjection(64slices,30second/projection).
Results: 99mTc‐HMPAO‐PEG‐NLsshowedasignificant
circulation tracer activity (7.74 ± 1.63%ID/g at 1 h
and 4.9±0.77 %ID/g at 4 h), with low tracer
accumulationintheliver(12.07±3.66%ID/gat1h
and 14.85 ± 1.3 %ID/g at 4 h). Heart toliver, spleen
andbackgroundratios(ROIs)for 99mTc‐HMPAO‐PEG‐
NLs was 1.25, 4 and 4.28 respectively at 2 h which
changedto1.06,1.75and2.51respectivelyat24h.
Conclusion: The 99mTc‐HMPAO‐PEG‐NLs with a
prolonged blood circulation time could be an
excellentRBCalternativeforscintigraphy.
S51
S‐1
Initial experience of Ga‐68 DOTANOC
imaginginNETinatertiarycaremedical
center
AryaA,SinghD,GambhirS,AgarwalG*,Agarwal
A*,PradhanPK
Department of Nuclear Medicine, Department of
Endosurgery*, Sanjay Gandhi Post Graduate Institute of
MedicalSciences,Lucknow,India
Background: The aim of this study was to analyze
retrospectivelytheutilityofGa‐68DOTANOCinPET‐
CT imaging in the management of neuroendocrine
tumors.
Materials and Methods: PET‐CT study was done in
21patientsofneuroendocrinetumors[NET’s],which
included 14 males & 10 females, aged 7 to 62 yrs.
They underwent PET‐ CT study after IV injection of
74‐148 MBq of Ga‐ 68 DOTANOC. Pt. was given oral
contrast.Imageswereacquired1hr.lateronPET‐CT
scanner [Biograph 64 slice scanner, Siemens,
Germany].
Results: The NET’s included 4 cases of
phaeochromocytoma, 4 cases of MTC, 4 cases of
carcinoid,1caseofMEN‐1,3casesofparaganglioma,1
case of neuroblastoma, 4 cases of gastroentero‐
pancreatic NET’s which included duodenal,
retroperitoneal,esophageal&pancreatictumors.Each
case was analysed with respect to the clinical context
which revealed Ga‐68 DOTANOC avid in 3 cases of
pheochromocytoma, 1 case of neuroblastoma, 3 cases
of medullary carcinoma of thyroid, 1 case of MEN I, 3
cases of carcinoid, 3 cases of gastroenteropancreatic
tumors i.e. duodenal, pancreas, esophagus, 2 cases of
paraganglioma. There was no radiopharmaceutical
concentration in 1 case of pheochromocytoma, one
caseofmedullarycarcinomaofthyroidandonecaseof
carcinoid and one case of paraganglioma. The
interesting aspects of this molecular imaging will be
demonstratedinformofclinicalcase.
Conclusion: This early experience of PET‐CT using
Ga‐68 DOTANOC in diverse patients of
neuroendocrine tumors provide further insight into
Ga‐68 labeled positron imaging and for radionuclide
therapyinmetastaticneuroendocrinetumors.
S‐2
Evaluation the Clinical Efficacy of Knee
RadiosynovectomyinKuwaitPopulation
AnwarAl.Banna
MinistryofHealth,Kuwait
Radiosynoviorthesis (RSO) or radiosynovectomy
is a local form of radiotherapy for treatment of
resistant synovitis of individual joints resulting in a
restoration of the inflamed synovium. This study
S52
designed to assess the overall efficacy of RSO in
different synovial pathologies among Kuwait
population.ThestudyconductedinFarwaniaNuclear
Medicine Department in Farwania Hospital, Kuwait.
We did knee joints RSO using Yttrium‐90 intra‐
articular injection in 34 patients ranged from 19 to
69‐year‐old. A comprehensive pain evaluation
questionnaire were performed by patients and
recordedbeforeandafterthetreatmentforassessthe
efficacyofthetherapyinindividualpatient.Also,pre
and post imaging evaluation with two phase bone
scan and knee ultrasonography were obtained to
assess the response rate objectively. Seventy one
percent of patients showed significant therapeutic
relief; 20% partially relieved and 9 % had no
response. Our result data are keeping with
international publications. Also, a new approach of
Bremstrahlung SPECT‐CT images of the knee
following intra‐articular injection of Yttrium‐90 was
adopted to delineate intra or extra‐articular
distribution of the injected radiotracer. This novel
approach is not to date being reported for RSO and
appearstobepromising.
S‐3
FDG‐PET Brain Imaging Patterns in
Patients with X‐linked Dystonia
Parkinsonism
EduardoErastoS.Ongkeko
St.Luke’sMedicalCenter,Philippines
Background:X‐linkeddystonia‐parkinsonism(XDP)
or Lubag is a rare movement disorder that afflicts
mostly Filipino men. Diagnosis is based on the
clinical presentation and the establishment of an x‐
linkedrecessivepatternofinheritanceorbygenetic
confirmation. Objectives for this study are to
describe the brain FDG distribution using PET
imaging in Filipino patients with Lubag including
asymptomaticcarriersandtodeterminedifferences
in striatal FDG utilization in those presenting with
predominant parkinsonism and those with
predominantdystonia.
Materials and Methods: Eleven male patients
havingclinicalmanifestationsofXDPanddiagnosed
by movement disorder specialists underwent an
FDG‐PET
scan.
Four
genetically‐proven
asymptomatic carriers and seven normal controls
werealsorecruitedforFDG‐PETstudies.Qualitative
and semi‐quantitative assessment using SUV and %
FDGuptakeofstriatalstructureswereobtainedand
comparedforeachgroup.
Results: Visual assessment revealed five of the 11
symptomatic patients having both caudate and
putaminal hypometabolism while the remaining six
symptomatic
patients
having
putaminal
hypometabolism alone. All four asymptomatic
carriershadnormalFDGPETstudies.Incomparison
with data obtained from normal control subjects,
there was significantly reduced FDG metabolism in
thecaudatenucleiandmoresointheputameninthe
symptomatic lubag group (P<0.05) but no
differences were observed between the
asymptomatic carriers and normal controls
(P>0.05). XDP patients having hypometabolism in
boththeputamenandcaudatenucleiappeartohave
longer duration of clinical disease than those with
putaminal hypometabolism alone (P<0.05). No
significant difference in striatal FDG metabolism
was documented between those having
predominant dystonia and those having
predominantparkinsonism(P>0.05).
Conclusions: This small series of patients
demonstrate that patients with the phenotypic
characteristics of X‐linked Dystonia Parkinsonism
have consistently poor glucose metabolism in the
putamen and various degrees of decreased glucose
metabolism in the caudate nuclei. Patients having
both caudate and putaminal hypometabolism
suggest that they have been symptomatic for a
longerperiodoftime.FDG‐PETcannotdiscriminate
between lubag patients presenting predominantly
with dystonic symptoms and those presenting
predominantly with parkinsonism. Lastly, FDG‐PET
didnotshowstriatalabnormalitiesinthecarriersof
XDPmutationthatwouldsuggestpreclinicaldisease
activity.
S‐4
Our experience use theconcentration of
thyroglobulin and anti‐thyroglobulin
antibodies in patient with differentiated
thyroid cancer after Radioiodine 131
treatment
Erdenechimeg S, Enkhtuya B, Enkh‐Amar T,
EnkhbatG
DepartmentofNuclearMedicine,FirstStateCentralHospital
ofMongolia
Background: The measurement of serum
thyroglobbulin (Tg) is the primary biochemical
marker used for disease surveillance, creating
challenges in monitoring patients with differentiated
thyroid cancer (DTC) for residual or recurrent
disease. Anti‐thyroglobulin antibodies (anti‐TgAbs)
elevatedinsomepatientsas well.Thepersistenceof
anti‐TgAbs,especiallyiflevelsarerising,mayindicate
persistent, recurrent or progressive thyroid cancer.
The aim of this study was to evaluate the
concentration of Tg and anti‐TgAbs in patients with
DTC 3and 6 months after radioiodine therapy to
analyzewhethertheraiseandcourseofanti‐TgAbsis
related to the clinical status of DTC patients or Tg
levelsbeforeandafterradioiodinetherapy.
Materials
and
Methods:
Pre‐treatment
measurements made in conditions of stimulation of
Tg secretion endogenous thyroid stimulating
hormone (TSH) (TSH≥30 mIU/L), while the
measurement after treatment were obtained in
conditions of suppression of Tg secretion (TSH ≤0.1
mIU/L).
Results: Concentration of Tg were decreased in the
serum of all patients with DTC 6 months after
radioiodinetherapy,aswellasmeanconcentrationof
anti‐TgAbs. Individual values of anti‐TgAbs in
patients with DTC after the radioiodine treatment
werediverse(decreased,increasedorunchanged).
Conclusion: The development and course of anti‐
TgAbs in DTC patients cannot be predicted by Tg
levelsbeforeandafterradioiodinetherapy.
S‐5
Future cardiac events in normally
diagnosed Gated myocardial perfusion
SPECT(GSPECT)
HamidAmer
King Abdulaziz Hospital for national Guards Alahsa –
KingdomofSaudiArabia
Background: Coronary heart disease (CHD) is a
major cause of mortality and morbidity in Europe
and USA and its management consumes a large
proportion of national healthcare budgets. Many
studies hadtested the prognosticvalueof a normal
myocardial perfusion scintigraphy; they concluded
that a normal MPI study is associated with a very
low rate of future cardiac events. In view of the
abovethisstudyisdesignedtodeterminetheriskof
future cardiac events after normal MPS in local
population and the influence of clinical risk factors
overtherateoffuturecardiacevents.
Materials and Methods: This was a retrospective
observational registry performed in a single center
in the Kingdom of Saudi Arabia. The data were
collected from the nuclear medicine database
identifying all the reported normal myocardial
perfusion scans between January 2008 and
December2011.Therewere290patientsidentified
withnormal
cardiac nuclear scans in the pre‐specified time
frame. Basic patient demographics were outlined
and the patients’ charts were reviewed looking for
any major cardiac events such as MI or sudden
death.Meanfollowupwas14.8months.
Results:
Demographic Data of the Patients: There were
290 patientsidentified with normal cardiacnuclear
scans in the pre‐specified time frame. 103 of these
patients were male accounting for 35% of the total
population. Average age at the time of examination
was60.6±11.8yearsandthehighestagegroupwere
between66and70years.RiskfactorsforCAD:The
patients were presented with one or more risk
factors.Outofthe290patients,61%werediabetic,
S53
75.2%werehypertensive,65.5%weredyslipidemic,
2.8%hadasignificantpositivefamilyhistoryofIHD,
7.2%weresmokers,and24.1%hadhistoryofCAD.
2.1% of the total patient populations had prior
CABG. 2.4% of the patients had prior percutaneous
coronary intervention (PCI). Most of the cases
presented with more than a single risk factor and
the highest group were carrying three risk factor.
Follow up Data: There were 2 patients that were
admitted with NSTEMI and went on to have
diagnostic angiograms. One of those two patients
underwent percutaneous coronary intervention
withstenting.Theotherpatienthadnon‐obstructive
CAD and was advi‐sed for medical management
only.Thesefindingsareconsistentwitha0.7%risk
ofcardiaceventsafteranegativescan.
Conclusion:ItisconcludedthatanormalMPIstudy
is associated with a very low rate of future cardiac
events. Women with multiple risk factors including
family history of CAD are more likely to sustain
events and require close surveillance for the
development of coronary disease. However the
above findings demonstrate that the risk of major
cardiac eventsafter a negative nuclear cardiac scan
is low and is in keeping with the international
statisticsavailable.
S‐6
Heterogeneityanalysisindifferentiating
betweenmalignantandbenignFDG‐avid
thyroidnodules
Hendra Budiawan1,2, Gi Jeong Cheon1,3, Jin Chul
Paeng1, KeonWook Kang1,3, June‐Key Chung1,3,
DongSooLee1
1DepartmentofNuclearMedicine,SeoulNationalUniversity
Hospital,Seoul,Korea
2Department
of Nuclear Medicine, Mochtar Riady
ComprehensiveCancerCentre–SiloamHospitalsSemanggi,
Jakarta,Indonesia
3Cancer Research Institute, Seoul National University, Seoul
Korea
Background: Differentiating between malignant and
benign FDG‐avid nodules is still challenging. The
purposeofthisstudywastoassessifheterogeneityof
FDGuptakecouldbeuseful.
Materials and Methods: There were 27 malignant
nodules and 17 benign nodules. SUVmax, longest
diameter, HU, and coefficient of variation (CV) were
comparedbetweenthe2groups.CVwasobtainedby
dividing standard deviation of SUV by mean of SUV.
The volume of interest was made without using any
threshold,butbydrawingmanually.
Results: Malignant thyroid nodules tended to have
higher SUVmax and CV compared to benign nodules.
Longest diameter and HU were not significantly
different.
Conclusion:Malignantthyroidnodulesshowedmore
heterogeneous FDG uptake than benign nodules.
S54
Heterogeneity, represented by CV derived from
manual VOI, can be helpful in characterizing thyroid
nodules.
S‐7
Efficacyof 99mTc‐sestamibiSPECT/CTfor
minimally invasive parathyroidectomy:
Comparative study with 99mTc‐sestamibi
scintigraphy,SPECT,USandCT
HYLee
Snubh
Background: We evaluated the efficacy of 99mTc‐
sestamibi SPECT/CT for planning minimally invasive
parathyroidectomy(MIP),comparingwithdualphase
99mTc‐sestamibi scintigraphy, 99mTc‐sestamibi SPECT
andconventionalimaging(USandCT).
Materials and Methods: Thirty‐one patients (M:F =
10:21, range 35–78 years old) who showed high
serum parathyroid hormone (intact PTH) level were
99mTc‐sestamibi
included.
scintigraphy
was
performed 15 and 150 min after injection of 99mTc‐
sestamibi(555MBq),and 99mTc‐sestamibiSPECT/CT
wasobtainedjustafterthedelayedscan.Comparison
study between imaging modalities was done by
patient‐basedandlesionlocation‐basedanalysis.
The location of the lesion was confirmed by the
operativefinding.Anoperationwasperformedin24
patients. Seven patients had normal 99mTc‐sestamibi
SPECT/CT,andfollowedformorethan6monthsafter
SPECT/CT.
Results: Among 24 patients, parathyroid adenoma
was detected in 19 patients and the other 5 had
parathyroid hyperplasia (total 35 lesions). 99mTc‐
sestamibi scintigraphy detected abnormal uptake in
15 patients with 24 lesions. Conventional imaging
identified abnormal findings in 17 patients with 27
lesions. SPECT detected abnormal findings in 18
patients with 27 lesions. SPECT/CT identified
abnormal findings in 24 patients with 35 lesions.
SPECT/CT demonstrated 100 % sensitivity in a
patient‐based analysis. SPECT/CT exhibited
significantly better sensitivity than 99mTc‐sestamibi
scintigraphy, SPECT and conventional imaging
(p\0.05). All lesion location was correctly identified
to perform MIP. The final clinical diagnosis of 7
normal SPECT/CT patients was secondary
hyperparathyroidismon6monthsfollow‐up.
Conclusion: We correctly identified the precise
location of parathyroid adenomas or hyperplasia by
99mTc‐sestamibi SPECT/CT which was helpful to
performMIP.
S‐8
Breast
cancer
and
autoimmune
thyroiditis: Does the sodium iodide
symporterplayarole?
Jefferson R. Pagsisihan, Hyun‐Yeol Nam, Jae
SeonEo,June‐KeyChungandDongSooLee
Department of Nuclear Medicine, Seoul National University
Hospital,Seoul,SouthKorea
Background: Breast cancer is the most common
malignancy in women. Thyroid disease is likewise
prevalent in the female population. On whole body
PET/CT, increased thyroid gland uptake of F‐18
Fluorodeoxyglucose(FDG)issometimesencountered.
It may appear diffusely or focally increased. Sodium
iodide symporter is found in both the thyroid gland
and breast. This study aims to determine the
incidence and evaluate the clinical significance of
diffusely increased thyroidal uptake of F‐18 FDG in
breast cancer patients. This also aims to determine
the possible role of NIS in thyroid disease among
breastcancerpatients.
Materials and Methods: The study population was
comprisedof440adultfemalecancerpatients.Those
who were diagnosed with thyroid and ovarian
malignancy, as well as those with previous thyroid
surgery, were excluded. Whole body PET/CT images
andmedicalrecordswerereviewed.Thepresenceof
NISmRNAintheserumwasdeterminedusingnested
RT‐PCR.
Results: One hundred thirty‐three (30.2%) patients
had breast cancer while 307 (69.8%) had
malignancies other than breast cancer. Diffusely
increased thyroidal uptake was demonstrated in
18.8%and10.4%patientsinthebreastcancergroup
andnon‐breastcancergroup,respectively.Therewas
significant difference between these incidence rates.
Diffusely increased thyroid uptake was more
frequently noted in women 50 years old and above.
The average SUVmax of the thyroid gland in breast
cancer patients with diffusely increased thyroid
uptake (3.33) was significantly higher than in those
who did not exhibit increased thyroid uptake (1.25)
(P<0.0001). In the patients with diffusely increased
thyroid uptake, the average SUVmax of the thyroid
gland of the non‐breast cancer group (4.80) was
significantly higher than that of breast cancer group
(3.33)(P=0.021).Therewasnostatisticalsignificance
intheincidenceofdiffuselyincreasedthyroiduptake
with regards to cancer stage and hormone receptor
status. On further thyroid gland evaluation,
autoimmune thyroditis was noted in the breast
cancer patients with diffusely increased uptake. NIS
mRNA was detected in serum of the breast cancer
patientsandwasnegativeinallthenormalcontrols.
Conclusions: Diffusely increased thyroidal F‐18 FDG
uptake was more frequently exhibited in patients
with breast cancer. Further thyroid gland evaluation
revealed autoimmune thyroiditis. NIS mRNA was
detectedinserumofthebreastcancerpatients.These
are suggestive of an association between breast
cancer and autoimmune thyroiditis and the possible
role of NIS in the causation of this milder form of
autoimmunethyroiditis.
S‐9
Prediction of hepatocellualar carcinoma
recurrenceafterlivertransplantationby
18F‐FDG PET/CT using metabolic and
volumetricparameters
JinChulPaeng
SeoulNat’lUniversityHospital
Background: Our aim is to compare the various
parameters of 18F‐FDG PET/CT for prediction of
hepatocellularcarcinoma(HCC)recurrenceafterliver
transplantation(LT).
MaterialsandMethods:Total110HCCpatients(M:F
=89:21age=54.4±8.6yr)whounderwent 18F‐FDG
PET/CT and following LT (93 from living donor, 17
from deceased donor) were retrospectively enrolled.
Patientswerefollowedupformorethan1yr(mean=
27.4 ± 13.4 mo) by ultrasonography, enhanced‐CT,
and/or 18F‐FDG PET/CT. On preoperative 18F‐FDG
PET/CT, peak, maximum and mean standardized
uptake values (SUV) and tumor‐to‐background
[inferior vena cava (IVC) or liver] ratio of SUV (TBR,
SUVmax divided by background) were measured as
metabolic parameters. Metabolic tumor volume
(MTV),totallesionglycolysis(TLG,SUVmeanmultiplied
by MTV) and uptake volume portion (UVP, TBR
multiplied by MTV) were also measured as
volumetric parameters and compared for prediction
ofHCCrecurrence.
Results: Thirty patients (27.3%) exhibited HCC
recurrenceafter11.5±9.0mo.Onreceiveroperating
characteristic (ROC) curve analyses, various PET
parameters had significant area under curve (AUC:
TBR by IVC = 0.913, UVP by liver = 0.896). On log‐
rank test, TBR by IVC, UVP by liver, Milan criteria,
tumor largest diameter, tumor number, vascular
invasion,Tstageandtumorgradeshowedsignificant
predictivevaluesforrecurrence.Multivariateanalysis
by Cox‐regression revealed that TBR by IVC, UVP by
liver and vascular invasion were significant
predictors, with highest odds ratio (OR) on UVP by
liver[OR=12.0(3.0‐47.1)].
Conclusion:Amongseveralmetabolicandvolumetric
parametersof 18F‐FDGPET/CT,TBRandUVPbyIVC
exhibited the highest predictive value for prediction
of HCC recurrence after LT. 18F‐FDG PET/CT is an
effective imaging method for prediction of tumor
recurrenceafterLTforHCC.
S55
S‐10
Role of 11C‐Methionine PET/CT for
amygdalaenlargement
KimiteruIto
Tokyo Metropolitan Geriatric Hospital and Institute of
Gerontrogy
The aim of this study is to explore amygdalar
enlargement (AE) pathogenesis as one of
thepotentialepileptogenic lesions by using 11C‐
methionine (Met) positron emission tomography
(PET)/computed tomography (CT). Forty‐four
patientswithtemporallobeepilepsy(TLE)including
twenty‐six AE underwent Met PET/CT. Met uptake
was visually assessed. AE were diagnosed with MRI
findingsbyneuroradiologists.Sevenoftwenty‐sixAE
casesshowedMetpositive.AllTLEwithoutAEcases
showed Met negative. Lesion/normal ratio of Met
uptake was significantly higher in the AE with Met
positive group than in the AE with Met negative or
TLE without AE groups. Finally, twelve patients
underwent surgical treatment. Pathological evidence
revealed 1 low grade glioma, 1 ganglioglioma, and 1
focal cortical dysplasia (FCD) in the AE with Met
positive group, 2 FCD and 1 hamartoma in the AE
withMetnegativegroup,and6non‐tumorlesionsin
the TLE without AE group. Met PET/CT can detect
hiddenbraintumorsinTLEpatientswithAE.
S‐11
Ga‐68labelledPSMAintheevaluationof
biochemical relapse in prostate cancer:
Preliminaryresults
MadhaviTripathi,RajeevKumar,ParthaSarathi
Chakroborty, *Amlesh Seth, Shambo Guha Roy,
Parul Thukral, Sanjana Ballal, Chandrasekhar
Bal
DepartmentofNuclearMedicineandPETand*Department
ofUrology,AllIndiaInstituteofMedicalSciences,NewDelhi,
India
Background:Tilldate,thedetectionoflesionsinthe
context of biochemical recurrence of prostate cancer
(PC) is a major challenge for all imaging modalities
andoneofthekeyissuesinmanagement.Theaimof
the present study was to evaluate the role novel
generatorbasedPETradiotracerGa‐68labeledPSMA
inPCwithbiochemicalrelapse.
Materials and Methods: Eight patients with
biochemicalrelapseofprostatecancermeanPSA=9.9
ng/ml (range=1.14 to 31.0 ng/ml) underwent Ga‐68
PSMA and conventional imaging for evaluation of
relapse.PlainandfusedGa‐68PSMAPET/CTimages
were viewed for visual interpretation. Radiotracer
uptakethatwasvisuallyconsideredasPCwassemi‐
quantitativelyanalysedbymeasuringSUVmax.
S56
Results: Lesions characteristic of prostate cancer
were detected in five (62.5%) patients using Ga‐68
PSMA,thisincludedtwopatientswithPSAlevels<2.8
ng/ml.Allcaseswithrecurrenceintheprostaticbed
(two) and one case with prostatic and lymph node
metastasis were proven on MRI. In one case with
marrow metastasis on Ga‐68 PSMA, bone scan was
normal but MRI proved the marrow lesion. One case
withpleuralandlungmetastasiswasprovenonCT.
Conclusion: Thus Ga‐68 PSMA correctly localized
diseasein62.5%ofpatientswithbiochemicalrelapse
of PC. Further evaluation in a larger number of
patients is planned to establish its true influence on
patientmanagement.
S‐12
Diagnostic performance of 18F FDG PET
CTinpatientspresentingwithsecondary
neck nodes from an unknown primary
malignancy;AnInstitutionalExperience
ShanmugaSundaramP
Department of Nuclear Medicine and PET CT, Amrita
institute of Medical Sciences and research centre (Amrita
VishwaVidyapeetham),Cochin,Kerala,India
Background:Inmanypatientspresentingwithneck
nodal metastases from an unknown primary the
primary tumor remains occult even after thorough
clinical and anatomical imaging investigations.
Whole body FDG PET CT is being increasingly used
for evaluation of these patients. We aimed to
evaluatethediagnosticperformanceofFDGPETCT
in patients with recently detected neck nodal
metastasesfromunknownprimary.
MaterialsandMethods:Studyincluded38patients
(male: female=30:8, age range=32‐80 years, mean
age=57.9±13.39years)withoneormorepalpable
cytologically
/histopathologically
confirmed
malignant neck node(s). All the patients had been
subjected to thorough physical examination,
endoscopies and anatomical imaging, but no
primarymalignancyhadbeenidentified.Astandard
protocol for whole body FDG PET CT was followed.
PET CT findings, FNAC or endoscopic findings from
PET guided/ directed biopsies of suggested occult
primaries (when applicable), and finally
histopathologies of the specimen (when applicable)
were correlated. Any FNA or biopsy finding from
suggestedmetastaticsiteswasalsocorrelated.
Results: Distribution of primary tumor sites
identified by PET CT included nasopharynx in 3
patients(27.2%),tonsilsin2(18.6%),esophagusin
2(18.6%),pancreasin2(18.6%),baseofthetongue
in1(9.0%)andbreastin1patient(9.0%).Detection
rateofoccultprimarybyFDGPETCTinourseriesis
28.9% (11 out of 38 patients). Assessment of
validity parameters for FDG‐PET CT showed a
sensitivity and specificity of 100% and 77.7 %,
respectively. The positive predictive value (PPV)
was 64.7% and the negativepredictive value (NPV)
was 100%. False positivity rate was found to be
22.2%. FDG PET CT study also detected other
lymphnodal and organ metastases. (a). In patients
with cervical nodal metastases (N staged patients,
total 26 patients): Extracervical lymphnodal or
contralateral cervical metastatic disease was
detected in 2 patients. Altogether distant skeletal
and soft tissue metastases were detected in 5
patients. (b).In patients with supraclavicular nodal
(SCN) presentation (total 12 patients): Extra SCN
lymphnodal metastatic lymphnodes in 5 patients
andoverallskeletalandsofttissuemetastaseswere
detectedin8patientsinthisgroup.OverallPETCT
detected other lymphnodal or organ metastases in
42%patients(16/38patients).
Conclusion: 18F‐FDG PET CT is an useful modality
fordetectingunknownprimaryaswellasothersites
of metastasis in patients presenting with lymph
nodalmetastasesinneckfromanunknownprimary
malignancy.
S‐13
Relationships between F‐18 FDG Uptake
and the Status of BRAF V600E Mutation
andGlucoseTransporter‐1Expressionin
thePapillaryThyroidCarcinomas
MinkiYoon
Department of Nuclear Medicine, Good Samaritan Hospital,
RepublicofKorea
Background: The purpose of this study was to find
out the utility of F‐18 FDG PET/CT in PTCs, the
association of the maximum standardized uptake
value(SUVmax)ofF‐18FDGPET/CTandthestatusof
BRAFV600Emutationandtheglucosetransporter‐1
(GLUT1)expressionwasevaluated.
Materials and Methods: Retrospective analysis was
performed in 33 patients with PTCs. F‐18 FDG
PET/CT was performed preoperatively and the
SUVmax was calculated in the region of interest. The
BRAF V600E mutation was detected by DNA
sequencing. Immunohistochemical study for GLUT1
expressionwasdone.
Results: The BRAF V600E mutation was detected in
63.6% (21/33) patients with PTCs and the GLUT1
expression was 72.7% (24/33). The SUVmax of PTCs
was significantly higher in the mutated BRAF group
thaninthewild‐typeBRAFgroup(8.6±6.7vs.4.1±2.6,
P<0.05). The SUVmax was not significantly associated
with the levels of GLUT1 expression in all patients
withPTCs(P=0.326).TheBRAFV600Emutationwas
significantly correlated with GLUT1 expression
(Spearman'srho=0.380,P<0.05).
Conclusion: The BRAF V600E mutation is
significantlyassociatedwithincreasedSUVmaxofF‐18
FDG PET/CT and GLUT1 overexpression in PTCs.
Preoperative F‐18 FDG PET/CT, which reflects the
glucose metabolism, can be an adjunctive method to
predicttheBRAFV600EmutationinPTCs.
S‐14
Efficacy of radiosynovectomy in the
treatment of chronic knee synovitis:
systematicreviewandmeta‐analysis
NasimNorouzbeigi
NuclearMedicineResearchCenter,Mashhad,Iran
Background: Knee joints are commonly involved
with various inflammatory and non‐ inflammatory
rheumatic diseases. Radiosynovectomy is being used
as a local therapeutic option to alleviate pain and
swelling in involved joints. The present study
evaluated the effectiveness of radiosynovectomy for
treatmentofchronickneesynovitis.
MaterialsandMethods:ThroughasearchofMedline
and SCOPUS with (Radiosynovectomy OR radio‐
synovectomy OR "radio synovectomy" OR "radiation
synovectomy" OR radiosynoviorthesis OR radio‐
synoviorthesis OR synoviorthesis OR "radiochemical
synovectomy" OR "radioisotope synovectomy") AND
(Re‐188ORY‐90ORSM‐153ORP‐32)askeywords,
9RCTswereenrolledintheanalysis.
Results:Theoutcomesofinterestwereoddsratioand
risk
difference of improvement in the
radiosynovectomy group compared to the control
group. Odds ratio and risk difference for SM‐153 plus
corticosteroid subgroup was 1.959[0.571‐6.725,
P=0.285] and 14.9% [‐17.1%‐47%, P=0.362]
respectively.ThesubgroupofY‐90pluscorticosteroids
showed pooled odds ratio and risk difference of
2.366[0.779‐7.188,P=0.129]and23.9%[‐1.7%‐49.4%,
P=0.67] and in the subgroup Y‐90 alone were
0.851[0.356‐2.036, P=0.717] and ‐2.3% [‐23.3%‐
18.7%,P=0.829]respectively.
Conclusion: Combination of Y‐90 colloid or Sm‐153
withcorticosteroidsinradiosynovectomyhavehigher
response rate compared to each of radioisotope or
corticosteroidtherapyalone.
S57
S‐15
S‐16
Comparison of 18F‐Fluoride PET/CT, 18F‐
FDG PET/CT and bone scintigraphy for
detectionofbonemetastasisinrenalcell
carcinoma:Apilotstudy
DelayedPresentationinHospitalinDTC
with Bone Metastasis; Patient’s Point of
View
Punit Sharma1,2, Sellam Karunanithi2, Partha
Rajeev
Kumar2,
Sarathi
Chakraborty2,
ChandrasekharBal2,RakeshKumar2
Department of Nuclear Medicine & PET/CT, Eastern
DiagnosticsIndiaLtd.,Kolkata,India
2Department of Nuclear Medicine, All India Institute of
1
Background: To evaluate the role of 18F‐Fluoride
PET/CTfordetectionofbonemetastasisinpatients
with renal cell carcinoma (RCC) and compare the
same with 18F‐FDG PET/CT and 99mTc‐MDP bone
scintigraphy(BS),whenavailable.
Materials and Methods: Total 36 patients (Mean
age: 52.5±14.1 years; Male/female: 27/9) with RCC
underwent 18F‐Fluoride PET/CT and there data
were analyzed. PET/CT images were analyzed by
two nuclear medicine physicians in consensus,
visually and semiquantitatively (SUVmax). Results of
18F‐Fluoride PET/CT were compared to 18F‐FDG
PET/CT
(n=16)
and
BS
(n=22).
Histopathology/clinical/imaging
follow
up
(minimum‐6 months) was used as reference
standard.
Results: Overall 18F‐Fluoride PET/CT showed
sensitivity of 100%, specificity of 94.4%, PPV of
94.7%, NPV of 100% and accuracy of 97.2%. It
demonstrated total 134 skeletal lesions of which
101 were characterized as metastasis and 33 as
benign. Corresponding CT changes were seen for
129/134 lesions. The mean SUVmax of the lesions
was 30.3±48.4. 18F‐Fluoride PET/CT and 18F‐FDG
PET/CTshowedsimilaraccuracyforvisualizationof
bone metastasis (93.7% vs. 100%; P=0.993).
However, 18F‐FDG PET/CT also demonstrated
extraskeletal metastasis in 6/16 patients. No
significant difference was seen between accuracies
of BS and 18F‐Fluoride PET/CT for visualization of
bonemetastasis(93.7%vs.100%;P=0.115),butthe
former showed more skeletal lesions (91 vs. 44;
P<0.0001).In4/22patients(18%)withnegativeBS,
18F‐Fluoride
PET/CT demonstrated skeletal
metastasis.
Conclusions: 18F‐Fluoride PET/CT shows high
diagnosticaccuracyfordetectionofbonemetastasis
inpatientswithRCC.Itshowscomparableresultsto
18F‐FDGPET/CTanddetectsmoreskeletallesionsas
comparedtoBS.
S58
SadafButt
Nuclear Medicine, Oncology and Radiotherapy Institute
(NORI),Pakistan
Boneisthesecondmostfrequenttargetofdistant
metastases in patients with differentiated thyroid
cancer (DTC). Prognosis and outcome of these
patientsisunfavorable.
We retrospectively reviewed Medical records of
PatientswithDTChavingbone,whoregisteredinour
hospital between 2000 and 2005. We found 57
patientshavingbonemetastasis.
All57patientshadbonemetastasisatthetimeof
presentation in hospital, and none developed it
duringthecourseoftheirtreatment.Itwasfoundthat
52% patients presented to the hospital due to some
complication of their bone metastasis, while 48%
patients were found to have bone metastasis during
baselineinvestigations.Patientswhopresentedtothe
hospital with complication of bone metastasis when
enquired about their neck disease‐ 59% had long
standing MNG and they did not want any treatment
because it was not causing any problems. Patients
whodidn’tknowabouttheirneckdiseasewere22%,
while19%patientshadpreviousthyroidectomy,and
were not properly guided or had misplaced
histopathologyreport.
AlthoughmajorityofpatientsofDTCpresentlate
with bone metastasis due to patient related factors
but a large percentage are being missed due to
hospitalrelatedfactors.WesuggestPatienteducation
as well as strict hospital policy for post‐operative
patient guidance to reduce patient presentation at
thislatestage.
S‐17
Unreported
Normal
RenographyStudy
Variant
of
SafdarRazaKamalBabar
NuclearMedicineDepartment,AseerCentralHospital,Abha,
SaudiArabia
NormalvariantsarecommonlyseeninDiagnostic
Studies across all modalities. One novel variant is
reported in this study that has not been described
before in the literature‐‐‐Focal Bladder Hot Spot. A
focalspotisnotedinthebladderduringtheexcretory
phase of Diuretic Renal Scintigraphy, that was then
correlated with Ultrasonography for any pathology.
All the cases show normal outline, thickness of the
urinary bladder wall suggesting an anatomical cause
ratherthanpathologicalcause.
S‐18
S‐20
Role of 18F‐FDG PET/CT in the diagnosis
andstagingofRosaiDorfmanDisease
Degree of myocardial perfusion & fatty
acid metabolism mismatch and its
correlation with the LV remodeling
following successfully reperfused ST
segmentelevatedmyocardialinfarction
SellamKarunanithi
Department of Nuclear Medicine, All India Institute of
MaterialsandMethods:Twentypatients(meanage‐
30.5 years, median‐32 years, range: 3‐45) with
clinically suspected and/or histopathologically
provenRosaiDorfmanDisease(RDD)underwent 18F‐
FDG PET/CT imaging for staging and/or localisation
ofthedisease.SUVmaxofnodalandextranodallesions
were measured. Results were verified with clinical
followupandhistopathology.
Results: Of the 20 patients with RDD, PET/CT
demonstrated pure lymph nodes (LN) involvement in
12 (generalised LN in 10; bilateral cervical LN in 2),
extranodal (retro‐orbitalmass) in2 andbothnodal &
extranodal(skeletal&softtissue)lesionsin6patients.
ThemeanSUVmaxofnodalandextranodallesionswere
6.5and5.8respectively.PET/CTemergedasexcellent
imaging modality for assessment the disease burden
with100%sensitivityandPPVfordetectingnodaland
extranodallesions.
Conclusion: 18F‐FDGPET/CTisaveryusefulimaging
investigationfordiagnosingandstaginginRDD.
S‐19
Metastatic central lymph node ratio can
characterize FDG‐avid lymph nodes in
papillarythyroidcancerpatients
SeongYoungKwon
ChonnamNationalUniversityHwasunHospital,SouthKorea
Background: We investigated the role of metastatic
central lymph node ratio (CLNR) for characterizing
FDG‐avidcervicallymphnodes(LNs).
Materials and Methods: Enrolled patients
underwent total thyroidectomy and had FDG‐avid
LNs incidentally detected on postoperative PET/CT.
CLNR (%) was calculated as follows: (number of
metastatic LNs/number of removed central LNs) x
100. We investigated clinicopathologic factors
significantforpredictingmetastasis.
Results: Of the 59 patients, 23 had metastatic LNs.
The frequency of pN1b stage and LN location were
significant factors for predicting metastases. Among
29 patients with FDG‐avid LNs located in mid to
lower neck compartments, high CLNR (>40%) was
the only significant factor on multivariate analyses
(OR,9.89;95%CI,1.54‐63.65;P=0.016).
Conclusion: CLNR was a significant factor for
characterizingFDG‐avidLNsespeciallylocatedinmid
tolowerneckcompartments.
Shankar Kumar Biswas, Masayoshi Sarai,
HiroshiToyama,MasatsuguIwase,YukioOzaki
Bangladesh Atomic Energy Commission, Fujita Health
UniversityHospital,Japan
Background: Discordant 123I‐β‐methyl‐iodophenyl
pentadecanoic acid (BMIPP) and 99mTc‐tetrofosmin
(TF) uptake is designated as viable dysfunctional
myocardium. But a little is known about it’s relation
with the left ventricular (LV) volume change /
remodeling. This study was designed to unravel the
impact of the degree of BMIPP‐TF mismatch and it’s
correlation with change of LV volume following
successfully reperfused ST‐segment elevation
myocardialinfarction(STEMI).
Materials and Methods: Twenty five patients (Age:
60±11yrs)withrecentSTEMIwereenrolled,andallof
them underwent emergency successful percutaneous
coronary intervention (PCI). BMIPP and TF cardiac
scintigraphy was performed on 7 ± 3 days of
admission. On 17 segment model, a difference of
BMIPPandTFdefectscoreby≥4wereconsideredas
mismatched defect. Conventional echocardiography
was performed within 24 hrs of admission, and at 3
months interval. Left ventricular end diastolic volume
index (EDVI), and end systolic volume index (ESVI)
wererecordedaccordingly.
Results: Out of 25 patients, 21 showed BMIPP‐TF
mismatcheddefectandrest4showedmatcheddefect.
Twelve patients (48%) showed reduction of left
ventricular EDVI, and 14 (56%) patients showed
reduction of ESVI over 3 months. Mismatched defect
score showed a significant correlation with the
relativechangeofEDVI(P=0.002,r=0.58)andESVI
(P=0.043,r=0.40).
Conclusion: The degree of dysfunctional viable
myocardium showed nice correlation with the
reduction of LV volumes following successfully
reperfusedSTEMI,andemergencyPCIcouldprevent
theupcomingventricularremodeling.
S59
S‐21
Risk Stratification in Patients with
Newly Diagnosed Stage III or IV Breast
Cancer by Volume‐based Metabolic
Parametersin18F‐FDGPET/CT
Su Yun Chen,Nuhad Ibrahim,Stephen T. Wong,
Hui WangandFranklin C.Wong
Shanghai Jiaotong University School of Medicine Xinhua
Hospital, China; The University of Texas, MD Anderson
CancerCenter,US
Background: The goal of this study was to
determine if the pretreatment 18F_FDG PET/CT
derived metabolic tumor volume (MTV) and total
lesion glycolysis (TLG) in patients with newly
diagnosed stage III or IV breast cancer (BC)may
haveaddedprognosticvalues.
MaterialsandMethods: A total of 129 consecutive
patientswithstageIII(54)orIV(75)BCunderwent
18F‐FDGPET/CTscanswereretrospectivelystudied.
MTVandTLGwereestimatedwithfixedandrelative
thresholds. MTVs and TLGs were evaluated for
associationwithprogressionfreesurvival(PFS)and
BC‐specific overall survival (OS). They were
compared with maximum standard uptake value
(SUVmax) and clinicopathological factors using
univariate and multivariate analysis to identify
independentprognosticfactors.
Results: Independent prognostic factors, MTV with
fixed SUV threshold of 3.0 and TLG with fixed
threshold of 2.5, were found to outperform SUVmax
and other volume‐based parameters to predict
disease progression and BC‐related death. After
stratified with volume‐ based parameters ，stage III
BC patients with high MTV or TLG had a similar OS
withstageIVpatientswithlowMTVorTLG(P=0.294
or0.381).StageIVBCpatientswithhighMTVorTLG
hadworsePFSandOSthansamestagepatientswith
lowMTVorTLG(P<0.001orP=0.002).
Conclusion: Both MTV and TLG have independent
prognostic value on survival in stage 1II or IV BC
patients. They may provide powerful prognostic
informationinpatientriskstratificationandleadto
bettermanagementoftheseadvancedstagepatients
whoaccountforthelargestmortalityratefromBC.
S‐22
Prognostic prediction in patients with
glioblastoma: intratumoral distribution
analysison11C‐methioninePETstudy
TadashiWatabe
OsakaUniversityGraduateSchoolofMedicine,Japan
Background: To evaluate the prognostic value of
pretreatment 11C‐methionine (Met) PET in
S60
glioblastoma (GBM) patients focusing on the
intratumoraldistribution.
Materials and Methods: Study population consisted
of14patientswithhistologicallyconfirmedGBM.Met
PET was performed before surgery followed by
chemotherapy and radiotherapy. Metabolic core
volume (MCV) was defined as total voxel volume
above the percent threshold of SUVmax. Intratumoral
distributionwasevaluatedbypercentmetaboliccore
volumeratio.
Results: Univariate analysis showed that %MCVR50,
%MCVR60, and %MCVR70 were significant factors
associatedwithoverallsurvival.Multivariateanalysis
demonstrated that MCV50 (p=0.021) and %MCVR60
(p=0.045) were the significant predictors for overall
survival.
Conclusion: This study demonstrated the prognostic
value of intratumoral distribution analysis of
metaboliccoreinGBMpatients.
S‐23
Comparison of Glomerular Function by
Tc‐99m Renal DTPA Scan with
Conventional Methods in Health and
Chronic Kidney Disease Amongst Sub‐
PopulationofSouthAsia
TahiraEjaz
NescomHospital,Pakistan
The glomerular filteration rate (GFR) is
traditionallyconsideredthebestoverallindexofrenal
function in health and disease (1). Because GFR is
difficult to measure in clinical practice, most
clinicians estimate the GFR from serum creatinine
concentration being the conventional method. This
study compares GFR by Tc‐99m renal DTPA,Gamma
camerascan(γGFR) with various conventional
methods amongst Pakistani population of different
agegroups.
The GFR was estimated with conventional
creatinine clearance methods (Cockcroft‐Gault(CG)
andModificationofDietinRenalDisease(MDRD)and
then compared with calculated GFR by Gamma
cameramethod(γGFR).TheγGFRwasconsideredas
areference.TheγGFRcorrelateswellwithCGformula
in subjects with normal and mildly reduced kidney
function(GFR>60ml/min/1.73m2),(P=0.0140).
For patients with moderately reduced renal
function (GFR 30‐60 ml/min/1.73m2), γGFR
correlates well with MDRD equation (P=0.0005). For
significantly reduced functioning kidneys (GFR˂30
ml/min/1.73m2), no correlation was found between
γGFR and conventional methods. This study further
augments the results of R.Kumaresan and Giri in “A
Comparison of Modification of Diet in Renal Disease
and Cockcroft‐Gault Equations for estimating
GlomerularFiltrationRateinChronicKidneyDisease
Patients”.
Therefore γGFR can be considered as an
acceptable method of assessing renal function in
healthandchronickidneydisease.
S‐24
Haemodynamically significant Coronary
Artery Disease detected by Myocardial
Perfusion Imaging can be predicted by
CarotidIntimaMediaThickness
Tapati Mandal, Lutfun Nisa, Nasreen Sultana,
FariaNasreen
Department of Nuclear Medicine, National Institute of
NuclearMedicineandAlliedSciences,Dhaka,Bangladesh
Background: The leading cause of myocardial
ischemia and / or infarction is coronary artery
disease (CAD). It is often the sequel of
atherosclerosis which may involve the entire
vasculatureaswellascoronaryarteries.Thechange
inthecoronaryarteriesduetoatheroscl;erosishave
variable haemodynamic effect on myocardial
perfusion, which can be assessed by SPECT
Myocardial perfusion imaging (MPI). Increased
Carotid Intima Media Thickness (CIMT) has been
used as a surrogate marker of atherosclerosis and
can predict cardiovascular risk. The aim of this
study was to assess the diagnostic performance of
CIMTforpredictionofhaemodynamicallysignificant
CADdetectedbyMPI.
MaterialsandMethods:Thisstudywascarriedout
in the National Institute of Nuclear Medicine and
Allied Sciences, Dhaka Bangladesh from January
2010toDecember2010.Thestudysubjectconsisted
of40pateientswithagerangingfrom40to50years
with cardiovascular risk factors. Myocardial
PerfusionImagingwasdonewithTc‐99mSestamibi
using one day stress and rest protocol. Carotid
IntimaMediaThicknesswasmeasuredwithBmode
highresolutionultrasoundscannerequippedwith7
MHzlineararraytransducer.
Results: The SPECT myocardial perfusion images
were semi quantatively analysed to obtain summed
stress score (SSS) which was used for optimum
correlation with the CIMT measurement in each
patient. According to the result of SPECT‐ MPI
patientsweredividedintotwogroups.Therewere23
patientswithnormalMPIinGroupAand17patients
withmyocardialperfusiondefectinGroupB.
In Group A with normal MPI, the corresponding
CIMT was either normal (<1 mm in 11 patients)
and/ormildlyincreased(1‐<1.3mmin12patients).
In Group B with perfusion defects, 16 of the 17
patientsshowedconsistentlyhighCIMT.Thedegree
ofCIMTwascomparedwiththeextentandseverity
of perfusion defects obtained by SSS and showed a
direct relationship between two para meters. This
relationship was further analyzed by the Pearson’s
correlation coefficient showing a positive
correlationofr=0.055whichwasstatisticallyhighly
significant (P<0.001). The accuracy of mean
maximum CIMT to predict haemodynamically
significant CAD measured from the area under the
receiver operation curve (ROC) was 0.824 which
was quite good. The sensitivity specificity, positive
predictive value, negative predictive value and
accuracy of different cut off values of CIMT were
measured.TheCIMTvalueof≥1.25mmwasfound
tobeapredictorofabnormalperfusiondetectedby
MPI.Therewasasensitivityof70.6%,specificityof
87%, positive predictive value of 80% and an
accuracyof80%atthisCIMTcutoffvaluetopredict
haemodynamicallysignificantCAD,detectedbyMPI.
The implication is that, a CIMT of ≥ 1.25 mm can
significantly predict the haemodynamic effect of
atherosclerotic lesions on myocardial perfusion in
patientswithrisksofCADwithanaccuracyofabout
80%.
Conclusion: A significant association is observed
between CIMt and MPI in patients with risk factors
for CAD. a cut off CIMT value of ≥ 1.25 mm
correlated most with the haemodynamic effect of
coronary artery stenosis on perfusion. Findings
from this small sample of patients, though
insufficient, suggest that CIMT can be used as
predictor of haemodynamically significant CAD,
detectedbyMPIandthusimprovepatientoutcome.
S‐25
Differentiation of Anterior Mediastinal
Lymphoma from Thymic Epithelial
Tumors by FDG‐PET
TomohikoYamane,AkiraSetoandIchieiKuji
Saitama International Medical Center, Saitama Medical
University,Hidaka,Japan
Background: The aim of this study is to evaluate
the ability of FDG‐PET fordifferentiatingmediastinal
malignantlymphomafromthymicepithelialtumors.
Materials and Methods: We retrospectively
analyzed 112 patients with mediastinal tumors.
Each maximum standardized uptake value (SUVmax)
of the tumor wasmeasured.
Results: Average SUVmax was 4.9 in thymoma
(n=27), 10.1 in thymic cancer (n=12), and 17.4 in
lymphoma(n=12).Thereweresignificantdifferences
among all groups (P<0.01). When SUVmax>11.2
was considered to be malignant lymphoma,
sensitivitywas100%andspecificitywas88%.
Conclusion: Anterior mediastinal lymphoma has
significantly higher FDG uptake than thymoma and
thymic cancer. FDG‐PET can be an important
modalitytodistinguishthesetumors.
S61
S‐26
Effect of 131I Therapy for Differentiated
Thyroid Carcinoma on Parathyroid
Function
ShuminYang
First Affiliated Hospital of Kunming Medical University,
China
Background: To investigate the effect of radioactive
iodine (131I) for differentiated thyroid carcinoma
(DTC)onparathyroidfunction.
MaterialsandMethods:Serumparathyroidhormone
(PTH)andcalcium(Ca)levelsweredeterminedin30
patients with DTC pre‐treatment (baseline group)
andatthe6thand12thmonthsof 131Iadministration
forthyroidremnantablation.
Results: Compared with the baseline group
respectively, serum PTH and Ca levels of the 6th
month group and 12th month group were on the
uptrendwithnostatisticalsignificance(P>0.05).The
difference of serum PTH and Ca levels between the
6thmonthgroupandthe12thmonthgroupwasnot
significant(P>0.05).
Conclusion: There was no significant effect of 131I
therapyforDTConparathyroidfunction
S‐27
68Ga‐exendin‐4
PET/CT is highly
effectiveinlocalizinginsulinomas
YapingLuo,QingqingPan,ZhaohuiZhu,Fangli
Department of Nuclear Medicine, Peking Union Medical
CollegeHospital,P.R.China
Background: The Surgical removal of insulinomas is
hamperedbydifficultiestolocalizeinsulinomasusing
conventional imaging procedures (CT, MR, EUS).
Recent studies showed 111In‐ and 99mTc‐labelled
exendin‐4, targeting GLP‐1R, revealed high accuracy
in localizing insulinomas. However, because of
differentadvantagesanddisadvantagesofallGLP‐1R
targetingtracers(labelledwith 99mTc, 111In, 68Ga, 18F),
itisamatterofargumentifpositronnuclidelabelled
exendin‐4 is better for detecting insulinomas. The
objectiveofthisstudyistopresentanewmethodfor
the diagnosis of insulinoma with the use of 68Ga‐
NOTA‐exendin‐4usingPET/CT.
Materials and Methods: A prospective study was
performed in 11 consecutive patients with proven
clinical
and
biochemical
endogenous
hyperinsulinemic hypoglycemia. All patients
underwent contrast‐enhanced CT and 99mTc‐HTOC
SPECT/CT. 68Ga‐NOTA‐exendin‐4 was administered
intravenously. Whole‐body PET/CT images were
performedat30‐60min,andabdomenimagesat2‐3
h if late scan is necessary. Surgical removal of the
insulinomaswasperformedsubsequently.
S62
Results: In 10 cases, 68Ga‐NOTA‐exendin‐4 PET/CT
successfully detected the insulinomas showing
significant intensityof radioactivity. Amongthese 10
cases, 5 cases were identified using contrast‐
enhanced CT, and only 1 case was positive in 99mTc‐
HTOC SPECT/CT. 68Ga‐NOTA‐exendin‐4 PET/CT was
negative in a G2 insulinoma, which showed high
uptakeof99mTc‐HTOC,andwasalsoidentifiedbyCT.
Conclusion: 68Ga‐NOTA‐exendin‐4 PET/CT is highly
effective in localization of insulinomas, and shows
great superiority to CT. 99mTc‐HTOC is a good
complementation to 68Ga‐NOTA‐exendin‐4 in
detectinginsulinomawithmalignantpotential.
S‐28
Evaluationofthepredictivevalueforthe
conversionofmildcognitiveimpairment
to Alzheimer’s disease by 18F‐FDG PET
andMRI:Amulticenterstudy
YoshitakaInui
NationalCenterforGeriatricsandGerontology
Background: The aim of this study was to examine
the predictive value for the conversion of mild
cognitive impairment (MCI) to Alzheimer’s disease
(AD)by18F‐FDGPETandMRI.
Materials and Methods: In total, 114 patients with
amnestic MCI were enrolled in this study and
followed periodically for 5 years. They underwent
18F‐FDG PET and MRI at baseline. An automated
analysis for 18F‐FDG PET was performed to calculate
the PET score and the cases were visuallyclassified
into the predefined dementia patterns. Z‐scores in
the medial temporal structurewerecalculatedusing
automatedVBMmethod.
Results: Forty‐nine MCI patients progressed to AD.
The diagnostic accuracy of PET score, the image
interpretation,and the VBM analysis was 57%, 82%,
and76%,respectively.
Conclusion: The diagnostic accuracy of PET image
interpretation showed the highest to predict
conversiontoADinpatientswithMCI.
S‐29
EstablishmentandClinicalverificationof
a mathematical model for diagnosing
SPNwith18FDGPET/CT
YumeiChen
Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong
University,China
Backgrounds:Toestablishamathematicalmodelfor
diagnosing the solitary pulmonary nodules (SPN)
with 18FDG PET/CT and to verify the established
mathematicalmodel.
MaterialsandMethods:Inthefirstpart,182patients
withSPN(115malignance,67benign)fromJan2005
toFeb2010werecollectedinthestudy.Clinicaldata
including 12 items (age, gender, maximum diameter,
site, density, border of tumor and parenchyma,
lobulation, spiculation, pleural retraction sign,
vascularconvergence,FDGuptake)wereanalyzedby
univariate and multi‐variate statistical method. The
mathematical model was obtained from binary
Logisticregression.Inthesecondpart,Aprospective
studyincluded109patientswithSPN(67malignance,
42 benign) from Jan 2011 to Jun 2012. Clinical data
including 7 items (age, density, border of tumor and
parenchyma, lobulation, pleural retraction sign,
vascular convergence sign, FDG uptake) were
incorporated into the mathematical model. The
diagnosticresultswerecomparedbetweenthemodel
and2seniordoctorswithrichexperienceinreading
PET/CTimaging.
Results: The mathematical model established by
binary Logistic regression was: P=ex/(1+ex), X=‐
4.146+0.041×age+2.226×density ‐1.053×border of
tumor
and
parenchyma
+1.211×lobulation
+2.579×vascular
convergence
+1.954×pleural
retraction sign +0.286×SUVmax. The AUCs of
mathematical model was 0.889±0.025 which was
better than the AUCs of SUVmax (AUC=0.729±0.038,
P<0.05). The clinical value for diagnosing the SPN
with mathematical model was verified with
sensitivity of 95.52%, specificity of 69.05%, positive
predictivevalueof83.12%,negativepredictivevalue
of 90.63%, accuracy of 85.32%. The diagnostic
efficiency from doctors was also obtained with
sensitivity of 97.01%, specificity of 52.38%, positive
predictivevalueof76.47%,negativepredictivevalue
of 91.67%, accuracy of 79.82%. The AUCs of
mathematical model were 0.887±0.034, while the
AUCsofthediagnosticresultsfromthedoctorswere
0.747±0.053(P<0.05).
Conclusion: The mathematical model established by
binary Logistic regression has high diagnostic value
for estimating the character of SPN and will be used
inclinicalpracticewell.
group, it is observed that RAI therapy is
becoming a common option for definitivetherapy
aspersistent remission isexpectedin1/3rdofcases.
The objective was to evaluate the outcome of I‐131
therapy in thyrotoxicosis in childhood and
adolescence.
Materials and Methods: This was a retrospective
study of 32 thyrotoxic patients (10‐17.9 years) who
received I‐131 therapy during January 2001 to
December 2012 in the thyroid division of National
Institute of Nuclear Medicine & Allied Sciences
(NINMAS). ATDs were given before RAI therapy and
therapy doses were calculated based on the size of
thethyroidanditspercentageuptakeat24h.Gender,
duration of antithyroid drug (ATD) treatment,
hormonal status, RAIU, ultrasound, thyroid scan,
dosage and number of therapies and post therapy
thyroid status at 6 monthswererecorded.
Results: 32 patients (87.5 % F, 12.5 % M) treated
withI‐131 were analyzed to assess the effectiveness
of therapy as related to dose and gland size. The
patients were classified into 2 groupsaccording to
treatment success (euthyroid and hypothyroid) and
treatment failure (hyperthyroid). There were no
significant differences in age, gender, duration of
ATD treatment, 2 and 24 h I‐131 uptake, thyroid
weight, and total I‐131 dose between these two
groups. The average age at diagnosis was 14.9±3.4
years. Allchildrenand adolescentsreceived single or
multipleI‐131dosesbetween6to 14mci. Sixmonths
after treatment, 31.25% of the patients were
hyperthyroid, 25% euthyroid and 43.75% were
hypothyroid.Of the 10 cases withhyperthyroidism,
8 needed a second dose and finally reached a
hypothyroidstate.
Conclusion: I‐131therapy is safe and effective for
thyrotoxicosis in childhood and adolescence. It is
suitable as a good second‐linetherapyforpatients
with severe complications, those who show poor
compliance, and those who fail to respond to ATD
treatment.
S‐30
Outcome of 131‐radioactive iodine
therapy in the treatment of childhood
andadolescentthyrotoxicosis
ZeenatJabin,NurunNahar,RaihanHussain
National Institute of Nuclear Medicine and Allied Sciences
(NINMAS),Bangladesh
Background: Treatments for thyrotoxicosis in
children and adolescents are not always simple
and easy.Thoughaclinicaltrialwithoralantithyroid
drugs (ATDs) remain the preferred choice inthisage
S63
Author
Abid Jafri Mona
Abrar, ML
Agarwal, A
Agarwal, G
Agarwal, Vishal
Agrawal, Archi
Ahmad, Maqsood
Ahmed, Parvez
Ahmed, Munir
Ahmed, Tasnim
Al.Banna, Anwar
Alqaseer, M
Amer, Hamid
Arya, A
Aryana, Kamran
Ashfaq , Afshan
Bal, C. S
Bal, Chandra Sekhar
Baljinder , Singh
Ballal, Sanjana
Banerjee, S
Baodan, HUANG
Begum, Fatima
Begum, Nasrin
bhatt, V
Bhayana, Ridhima
Bieu, Bui Quang
Binh, Dang An
Budiawan, H
Budiawan, Hendra
Butt, Sadaf
Chakarborthy, Avik
Chakraborty, Partha Sarathi
Chang, Chia-Chi
Chaudhary, PR
Chen, Ji
Chen, Su Yun
Chen, Xiangrong
Chen, Yangchun
Chen, Yi-Chieh
Chen, Yumei
Chen, Zhengping
Cheng, Mei-Fang
Cheon, Gi Jeong
Chitkara, Ajay
Cho, Ihnho
Chowdhury, Shariful Islam
Chung, June-Key
Chuttani, Krishna
Cui, Quancai
Dabbagh kakhki, Vahid Reza
Darmawan , B
David , Ng
Dede, F
Del Mundo, Karina
Dhull, Varun
Dhull, Varun singh
Dinesh, Sonia M
Ejaz, Tahira
Enkh-Amar, T
Author Index Abstract
O-3-10
P-2-9
S-1
S-1
O-1-9, P-1-8, P-1-9, P-1-10,
P-1-11, P-1-12, P-2-8
P-1-31
O-2-9, P-2-13, P-2-18
P-2-23
P-2-13, P-2-18
P-2-23
S-2
P-2-3
P-2-3, S-5
S-1, P-1-30
P-2-38
P-2-18, O-2-9, P-2-13
O-2-10, P-1-2
P-1-19, S-15, P-1-6, S-11
P-2-9, CE-2-4
S-11
P-2-4
CE-3-2
P-1-34
P-2-23
P-1-26
P-2-32
O-1-5, O-2-4
P-2-31, P-2-34
P-1-5
S-6
S-16
P-1-28, O-2-7
S-15, S-11
P-2-14
P-1-28
P-2-12
S-21
O-1-10, P-1-14
O-1-10, P-1-14
O-3-5
S-29
O-3-6
O-3-5, P-2-30
S-6
CE-2-4
CE-2-2
P-2-23
S-8, S-6
P-2-9
CE-1-4
P-2-38
P-1-5
CE-3-1
P-2-28
O-3-9
P-2-32
P-1-19, P-1-22
O-2-1
S-23
S-4
Author
Enkhbat, G
Enkhtuya, B
Erdenechimeg, S
Erdil, T.Y
Feliana
Fransisca VS, Rocksy
Fujiwara, Ken
Gambhir, S
Gambhir, Aashish
Gandhi, Arun C.
Ghai, Anchal
Ghosh, Sandipto
Gillani, Jaweria
Goh, Anthony
Gokhale, Shefali M
Guiping, LI
Gupta, Ravi Kant
Ha, Le Ngoc
Hang, Bui Dieu
Hapkido, Habusari
Hapsari Indrawati
Hassan, A
Hazari, Puja P
Hossain, Mosharruf
Huang, Chiun-Sheng
Huang, Wen-Sheng
Huang, Yih-Hwen
Hui, ZHANG
Hung, Guang-Uei
Hussain, Raihan
Ibrahim , Md
Ibrahim, Nuhad
Imeryuz, N
Inanir, S
Inui, Yoshitaka
Ishiguro, Massanobu
Ito, Hiroshi
Ito, Kengo
Ito, Kimiteru
Iwase, Masatsugu
Iwata, Kaori
Jaafari, Mahmoud Reza
Jabin Z
Jabin, Zeenat
Jaimini, Abhinav
James, Vivek M
Jelani, A
Jhang, Tien Tien
Jia, Bing
Jin, Xiaona
Johari Daha, Fariba
Kai, HUANG
Kamal Babar, Safdar Raza
Kang, KeonWook
Kartamihardja, AHS
Karunanithi, Sellam
Kato, Takashi
Kazmi, A
Khan, Q
Kim, Chun K
Kiran, GP
Abstract
S-4
S-4
S-4
P-2-28
O-3-7
O-3-7
P-2-11
S-1
O-2-1, P-1-16
P-1-31
P-2-9
P-1-28
O-3-3
CE-3-1
P-2-26
CE-3-2
O-1-7, P-2-32
O-1-5, O-2-4
P-2-31, P-2-34
O-1-2
O-2-5
P-1-15
P-2-9
P-2-23
P-1-32
P-2-14
P-2-30
CE-3-2
P-2-37
P-2-1, S-30
P-2-4
S-21
P-2-28
P-2-28
P-2-11, S-28
P-2-31
CE-2-3
P-2-11
S-10
P-2-36, S-20
P-2-11
P-2-38
P-2-24
S-30
O-2-1, P-1-16
P-1-16
P-2-3
P-2-7
CE-1-4
CE-1-4
P-2-38
CE-3-2
S-17
S-6
P-1-25, P-1-17
S-15, S-18
P-2-11
P-1-15
P-1-15
O-3-9
P-2-10
Author
Ko, Chi-Lun
Ko, Kuan-Yin
Kosik, Russell
Kosuda, Shigeru
Kuji, Ichiei
Kumar Biswas, Shankar
Kumar Jha, Ashish
Kumar Sahoo, Manas
Kumar, Narendra
Kumar, Abhishek
Kumar, Amit
Kumar, Kunal
Kumar, R
Kumar, Rajeev
Kumar, Rakesh
Kusumahstuti, KP
Kwatra, Neha
Kwon, Seong Young
Lam, Winnie
Lee, Dong Soo
Lee, HY
Li , Fanyong
Li, DU
Li, Fang
Li, Shanqing
Liang, Naixin
Liu , Ji-an
Liu, Chia-Ju
Liu, En-tao
Liu, Miao
Liu, Xingdang
Liu, Zhaofei
Liu, Zhuang
Lo, Mei-Fang
Lopez, Nilo C.
Loya, A
Lu, Ching-Chu
Lubiano, Oliver R
Luo, Jinmei
Luo, Yaping
Macaisa, Carla Mari M
Magsombol , Butch Maulion
Majeed, Yasir
Malapure, Sumeet Suresh
Mandal, Tapati
Maria , M D'Souza
Marina, Patricia
Martiana, Ryna Z
Masood, Khalid
Maus, Stephan
Meng, Yunxiao
Meshkat, CA
Meutia, S
Mishra, Anil K
Mishra, Ajiv
Mittal, Bhagwant R
Miyatake, Shin-Ichi
Moghe, S.H
Mokaddema, Mohshi Um
Momenypoor, Salimeh
Momtaz, Shamim
Abstract
O-3-5
P-1-32
O-2-6
P-2-33
S-25
S-20, P-2-36
P-1-31
P-1-19
P-2-9
O-2-2
O-2-1
O-1-4
P-1-2, O-2-10
S-11, S-15
S-15
P-1-25
O-3-9
S-19
CE-3-1
S-6, S-8
S-7
O-1-10, P-1-14
CE-3-2
CE-1-4, S-27
CE-1-4
CE-1-4
O-1-10, P-1-14
P-2-30
O-1-1
O-3-6
O-3-6
CE-1-4
P-2-16, P-2-17
O-3-5
P-2-22
P-1-15
P-2-19
P-2-5
CE-1-4
CE-1-4, S-27
P-1-24
P-1-23
P-1-15
P-1-21
P-2-35, S-24
P-1-16
O-1-6
O-3-11
P-2-18
O-2-8, P-1-27, P-1-29
CE-1-4
P-2-4
P-1-5
P-2-9
P-1-6
P-2-9
CE-3-3
P-1-28, O-2-7
P-1-34
P-2-38
P-2-1
Author
Mondal, Anupam
Mukherjee, Anirban
Mukherjee, A
Mulay, A.V
Mulyanto, Ivana Dewi
Murtaza, A
Nahar, Nurun
Naik , Nitish
Nakamura, Akinori
Nam, Hyun-Yeol
Nandy, Saikat
Nasreen, Faria
Nath, Khokon
Nazar, Aftab Hasan
Nhung, Nguyen Thi
Niaz, K
Nisa , L
Nisa, Lutfun
Norouzbeigi, Nasim
Nouman, Muhammad
Nugrahadi, T
Obaldo, Jerry
Ones, T
Ongkeko, Eduardo Erasto S
Ozaki, Yukio
Ozguven, S
Padma , S
Paeng, Jin Chul
Pagsisihan, Jefferson R
Pan, Qingqing
Pandey, A. K
Pandit, N
Patel, Chetan. D
Patel, N
Patel, V
Pawar, Yogita
Perveen, R
Pradeep, V.M
Pradhan , PK
Pradhan, Prasanta Kumar
Prakash, Om
Punit Sharma
Purandare, Nilendu C
Qureshy, Ahmad
Quynh Vy, Tran Vu
Rach, S.
Rafiqul Islam
Rajan , M.G.R
Rangarajan, V
Reyes, Trisha Noelle DJ.
Ridhima, B
Roy, Ambuj
Roy, Shambo Guha
Sachin Jain
Sadeghi, Ramin
Sadri, Kayvan
Sakhia, N
Saleem, M
Salekin, Simoon
Sarai, Masayoshi
Sarker, Azmal Kabir
Abstract
O-2-1, P-1-16
O-3-1, P-2-2
P-1-2
P-2-26
O-3-7
P-1-15
P-1-34, S-30
P-2-2, O-3-1
P-2-11
S-8
P-1-28, O-2-7
P-2-1, P-2-35, S-24
P-2-1
P-1-6
O-2-4
P-2-3
P-2-4
P-2-1, P-2-35, S-24
S-14
P-2-20
P-1-17, P-1-25
O-3-2
P-2-28
S-3
P-2-36, S-20
P-2-28
P-1-4, P-1-3, S-12
S-6, S-9
S-8
S-27
O-2-10
P-2-10
P-2-2, O-3-1
P-1-26
P-1-26
P-1-28, O-2-7
P-2-24
P-1-20
S-1
CE-1-2
P-1-26
S-15
P-1-31
O-2-9, P-2-13, P-2-18
P-2-31, P-2-34
P-1-26
P-2-23
P-1-28, O-2-7
P-1-31
P-2-27
O-1-7
O-3-1, P-2-2
S-11
P-1-6
P-2-38
P-2-38
P-1-26
P-2-3
P-1-34
P-2-36, S-20
P-2-1
Author
Sarma, Manjit
Satish, S
Sebastian, Paul
Seher, Saima
Seon Eo, Jae
Seth, Amlesh
Seto, Akira
Shagos , G. S
Shah, Kabiruzzaman
Shah, Sneha
Shahid , Abubaker
Shahid, Nouroze Gul Abubaker
Shao, Dan
Sharma, Rajnish
Sharma, Sarika
Sharma, Akshima
Sharma, Gautam
Sharma, P
Sharma, Rajnish
Sharma, Sarika
Shi, Jiyun
Shi, Ximin
Shukuri, Miho
Singh, D
Singh, Harpreet
Singh, Dhananjay K
Singh, H
Siswoyo, Alvita Dewi
Soeriadi, Erwin Affandi
Sohaib, Muhammad
Son, Mai Hong
Song, Le
Sreekumar, A
Srivastava, MK
Sultana , N
Sultana, Nasreen
Sultana, Sadia
Suman KC, S
Sun, Yu
Sundaram P, Shanmuga
Sutanto, Anyeliria
Syed, A. A
Thukral, Parul
Tiwari, R
Tiwary, Amrita
Toan , Tran Song
Abstract
P-1-3, P-1-4, S-12
P-1-3, P-1-4, S-12
P-1-20
P-2-25
S-8
S-11
S-25
P-1-3, P-1-4, S-12
P-2-23
P-1-31
O-2-9, P-2-18
P-2-13
O-1-1
P-2-9
P-2-9
O-2-10
O-3-1, P-2-2
P-1-2
O-2-1, P-1-16
CE-2-4
CE-1-4
CE-1-4
CE-1-3
S-1
P-2-9
P-2-15
P-1-2
O-2-3
O-3-8
O-3-12
O-1-5, O-2-4
P-1-18
P-1-20
P-2-10
P-2-4, P-2-24
P-2-35, S-24
P-1-34
P-1-2
P-2-16
P-1-3, P-1-4, S-12
O-3-7
P-1-15
S-11
P-1-26
P-1-1
P-2-34, P-2-31
Author
Tom, Andrea
Toyama, Hiroshi
Tri, Tran Minh
Tripathi, Madhavi
Tseng, Jeffrey
Tseng, Ping-Huei
Tumapon, Deverly
Turner, J. Harvey
Turoglu, H.T
Tzen, Kai-Yuan
Varun, D
Varuna, Chafied
Vijayant, V
Vyas, R.K
Wadhwa, J
Wang, Fan
Wang, Hui
Wang, Mengzhao
Wang, Shu-xia
Wang, Yuankai
Watabe, Tadashi
Watts, Ankit
Wiyanto, J
Wong, Franklin C.
Wong, Stephen T
Wu, Kwan-Dun
Wu, Vin-Cent
Wu, Yen-Wen
Yamamoto, Seiichi
Yamane, Tomohiko
Yang, Shumin
Yang, Song-Han
Yen, Ruoh-Fang
Yilmaz, Y
Yin, Wong Wai
Yongshuai, QI
Yoon, Minki
Younis, Numair
Yudistiro, Ryan
Zaheer, Sumbul
Zakavi, Seyed Rasoul
Zaman, Areesha
Zhang, Weifang
Zhang, Yanyan
Zheng, Kun
Zhu, Zhaohui
Abstract
O-2-6
P-2-31, P-2-36, S-20
P-2-31
S-11
O-2-6
P-2-30
O-3-2
CE-1-1
P-2-28
P-2-19, P-2-30
O-1-7
O-3-11
P-1-13
P-1-26
P-2-10
CE-1-4
S-21
CE-1-4
O-1-1
P-2-16, P-2-17
S-22
P-2-9, CE-2-4
P-1-17
S-21
S-21
P-2-19
P-2-19
P-2-30
CE-2-1
S-25
S-26
P-2-6
P-1-32, P-2-19, P-2-30
P-2-28
CE-3-1
CE-3-2
S-13
O-2-9, P-2-18
O-3-7
CE-3-1
P-2-38
P-2-13, P-2-18
P-1-18
P-1-18
CE-1-4
CE-1-4, S-27
INSTRUCTION TO AUTHORS 1- Editorial policy
Asia Oceania Journal of Nuclear Medicine &
Biology (AOJNMB) is a peer reviewed biannual
journal and serves as the official publication of
Asia Oceania Federation of Nuclear Medicine and
Biology (AOFNMB). AOJNMB publishes material
of interest to physicians and scientists working in
the fields of nuclear medicine & biology. The
journal is an open-access free e-Journal which is
sponsored and published by Nuclear Medicine
Research Center (NMRC) in Mashhad University
of Medical Sciences (MUMS). A limited number of
journals in print form is also published. AOJNMB
publishes a variety of articles including original
laboratory and clinical investigations, metaanalyses, short communications, technical notes,
case reports and letters to the editor. Also
occasionally, invited reviews and continuing
education will be published. In preparing
manuscripts, authors should follow the Uniform
Requirements for Manuscripts Submitted to
Biomedical Journals: Writing and Editing for
BiomedicalPublications
(http://www.icmje.org/urm_full.pdf).Manuscripts,
including figures and tables, must be original and
not under consideration for publication elsewhere.
Ethics and malpractice statements of the Asia
Oceania Journal of Nuclear Medicine & Biologyare
based on COPE’s Best Practice Guidelines for
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Biology, Nuclear Medicine Research Center,
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Post Code: 91766-99199
Tel: +98-51-38400494 (Saturday-Wednesday;
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All manuscript should be submitted and
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Rasoul Zakavi at the address of editorial office.
3- Legal and ethical issues
Submission of any manuscript to AOJNMB
signifies that it is original and it has not been
published anywhere before (except as a
congress abstract of no more than 350 words)
nor it is under consideration by another
journal. By virtue of the submitted





manuscript,
the
corresponding
author
acknowledges that all the co-authors have
seen and approved the final version of the
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provide all co-authors with information
regarding the manuscript, and obtain their
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authors must provide both the print and
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The Asia Oceania Federation of Nuclear
Medicine and Biology and the publisher
(MUMS) will not be held legally responsible
should
there
be
any
claims
for
compensation.The authors are responsible for
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accuracy of the bibliographic information.
At the time of submission of the manuscript,
all authors must disclose any type of conflict of
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authors
should
include
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appointments relating to or in connection with
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article. Authors should declare sources of
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phrase ‘No potential conflicts of interest were
disclosed’ should be written in the
acknowledgement.
All manuscripts reporting the results of
experimental investigations involving human
subjects should include a statement,
confirming that informed written consent
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For animal studies, it must be in compliance
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All prospective clinical trials must be
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author(s) can post a copy of the published article
on his/her own website or his/her institution’s
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of the AOJNMB. The author(s) may republish the
article in a book written or edited by
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Acknowledgement,
Tables.
5- Article types
 Original articles: Manuscripts reporting the
results of original researches in preclinical,
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of individual studies, after a comprehensive
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 Short communications: A short report from a
research work will be published as short
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 Case reports: An important and rare
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journal prefers systematic reviews. The
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on controversial issues which is published in
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than 12 months)
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book reviews, upcoming events, meeting
reports and news items may be considered
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It should contain a Maximum of 350 words
divided in 4 sections preceded by headings:
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6- Manuscript submission
All manuscripts should be submitted online
using
online
submission
system
at
http://aojnmb.mums.ac.ir. You need to sign up
and log into the system for submission of your
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you can send an email to [email protected]
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The manuscript should have the following
sections: Title, Abstract, Main document,
References,
Figures
and
7-1: Title page
Title page should include in following order :
Title (please keep it short and informative), Full
first name and surname (and middle name
initials) of all authors, Affiliation (s) and e-mail
address(es) of all authors, Corresponding author’s
Full name, postal address, e-mail address,
Telephone and Fax number(s) and a short
running title of no more than 40 characters.
7-2: Abstract
7-3: Main document
7-3-1: The abstract must be the first page of Main
document. For original articles, the following
sections should be included: Introduction,
Methods, Results, Discussion and Conclusion. For
reporting Clinical Trials, please follow reporting
requirements
published
by
CONSORT:
http://www.consort-statement.org/consortstatement (There is no maximum word limit, but
it is preferable to keep Maximum word count at
6000 and Maximum references at 40).
7-3-2: For short communications and technical
notes, the following sections should be included:
Introduction, Methods, Results, Discussion and
Conclusion. (Maximum word count 3000 and
Maximum references 20)
7-3-3: For case reports, three sections of
Introduction, Case report and Discussion are
required. (Maximum word count 3000 and
Maximum references 20)
7-3-4: For Meta-analyses, Introduction, Methods,
Results, Discussion and Conclusion should be
included. Please use PRISMA statement for
reporting
your
work:
http://www.prismastatement.org/statement.htm (There
is
no
maximum word limit, but it is preferable to keep
Maximum word count at 6000 and Maximum
references at 40)
7-3-5: For review articles; (There is no maximum
word limit, but it is preferable to keep Maximum
word count at 6000 and Maximum references at
40)
7-4: Formatting
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Use MS Word 97 or later versions.
Use plain normal fonts (12 Times New
Roman) with double space formatting
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throughout the document including abstract,
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Number pages consecutively, beginning from
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of the page.
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Use the equation editor or MathType for
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The abbreviations should be used according
to Système Internationale (SI) nomenclature
and units and they should be explained the
first time they are used in the manuscript.
All units of radioactivity should be based on
the SI system i.e., Bq, Gy, Sv, etc. Chemical
formulae should be written according to the
recommendations of the American Chemical
Society.
7-5: Acknowledgement
Acknowledgements, sponsorship or grants
should be written after the main text and before
the references.
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The references should be listed consecutively in
order of citation in the manuscript. All references
must be cited either in text, table or figures.
Unpublished data and personal communications
cannot be cited. The AOJNMB uses Vancouver
style for references. For citation of journals, all
authors should be listed if the number of authors
were 6 or less. If not, please list the first 6 authors
followed by et al. A paper published online but not
in print can be cited using the Digital Object
Identifier (DOI). A web document can be cited
using the URL address. Using ENDNOTE or
similar soft ware and selecting the Vancouver
style (parenthesis) in Bibliographic Output Style
will facilitate correct reference citation.
Here are samples of citation styles:
a) Journal article (With 6 or less authors)
Palestro CJ. In vivo leukocyte labeling: The
quest continues. Journal of Nuclear Medicine.
2007; 48(3):332-4.
b)
Journal article (With more than 6 authors)
Intenzo C, Jabbour S, Miller JL, Ahmed I,
Furlong K, Kushen M, et al. Subclinical
hyperthyroidism: Current concepts and
scintigraphic imaging. Clinical Nuclear
Medicine. 2011; 36(9):e107-e113.
c)
Book
Walsh
G.
Proteins:
biochemistry
and
biotechnology. 2nd ed. Chichester: John
Wiley & Sons; 2002.
d)
Book chapter
Moallem SA, Balali Mood K. Opioids and
opiates. In: Mozayani A, Raymon LP,
editors. Handbook of drug interactions: A
clinical and forensic guide. 1st ed. Totowa:
Humana Press Inc; 2004. p. 123-149.
e)
Epub; Article by DOI:
Daliri M, Shafiei S, Zakavi SR, Dabbagh
Kakhki VR, Sadeghi R. Application of
(99m)Tc-denatured
red
blood
cells
scintigraphy in the evaluation of posttraumatic spleen auto-transplantation. Rev
Esp Med Nucl Imagen Mol. 2012 Nov 12.
doi:pii:
S2253-654X(12)00212-0.
10.1016/j.remn.2012.09.004.
f)
Online document:
RCT critical appraisal sheet In: Critical
Appraisal Sheets, Center for Evidence Based
Medicine
2012.
http://www.cebm.net/index.aspx?o=1157.
Accessed 3 Dec 2012.
7-7: Figure legends
Figure legends should be written after
references, each in a separate sheet preceding
with figure number (Figure 1). The figure legends
will be published below the figure. The legend
should not be included in the figure file. All
figures must be cited in the manuscript and
numbered consecutively using Arabic numerals.
7-8: Tables
Tables should not be sent as figures or as
separate file, they should be inserted at the end
of the manuscript, each in a separate sheet.
Tables are expected to be self explanatory, should
supplement and not duplicate the text and
numbered consecutively in order of appearance in
the text and using Arabic numerals. Put
horizontal line at the top of the table, below
column headings and at the bottom of it. Do not
use vertical line in the tables.
8- Figures and artworks
Figures and artwork should be submitted as
separate files in JPG or TIFF format. Figures
should be utilized only if they augment
understandability of the text. Drawings and
graphs should be professionally prepared in deep
black and white with no shading. Professionally
designed computer generated graphs with a
minimum of 300 DPI laser printer output is
preferable. Color photographs are welcomed.
Vector graphics containing fonts must have the
fonts embedded in the files. For lettering the
figures, use 8-12 point (only one size) Helvetica
fonts. Name each figure with the word “Fig”
followed by figure number without punctuation:
“Fig1”. If you include a figure from previous
publication, you must provide permission from
the copyright owner(s) for both the print and
online format.
9- Supplementary materials
Video clips, sound records, excel or SPSS files
and other supplementary materials could be sent
for electronic linking to the manuscript in the
website. MPEG-1 format (.mpg) should be used
for video clips. Supplementary documents are
encouraged to be sent as .PDF files if possible.
Please name each supplementary file beginning
with the name of first author (eg. Bom-video.mpg,
Sadeghi-data.xls, etc). In text files you should
enter the full name of the article and the authors
as a header.
10- Cover letter
All manuscripts should be accompanied by a
cover letter. In the cover letter signed by
corresponding author on behalf of all authors, it
must be mentioned that the article is not
submitted to any other journal. A sample of
cover
letter
could
be
found
in:
http://aojnmb.mums.ac.ir/journal/authors.note
11- Peer review process
All manuscripts will be peer reviewed prior to
publication. Authors are encouraged to suggest
names of three expert reviewers, but selection
remains a prerogative of the Editor. The whole
review process depends on receiving referees’
comments and revising the manuscripts based on
these comments to the author and may take few
months. AOJNMB will try to make the time
between submission and final decision as short as
possible. On receipt of the revised article from the
author, and after final approving by the referees,
the letter of acceptance is issued to the author.
12- Acceptance/Rejection
You will be notified regarding acceptance or
rejection of the article by e-mail. Upon acceptance
and after editorial amendments, galley proof will
be sent to the corresponding author for final
correction. No major change in content or title is
accepted at this stage without editor’s approval.
Any addition or removal of an author from the
list of authors must be accompanied with a
written and signed agreement of the author(s) to
be added or deleted.

- Asia Oceania Journal of Nuclear Medicine and Biology

Transcription

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